In:
Obstetrics and Gynecology International, Hindawi Limited, Vol. 2016 ( 2016), p. 1-7
Abstract:
Introduction . To identify factors that determine blood loss during peripartum hysterectomy for abnormally invasive placenta (AIP-hysterectomy). Methods . We reviewed all of the medical charts of 11,919 deliveries in a single tertiary perinatal center. We examined characteristics of AIP-hysterectomy patients, with a single experienced obstetrician attending all AIP-hysterectomies and using the same technique. Results . AIP-hysterectomy was performed in 18 patients (0.15%: 18/11,919). Of the 18, 14 (78%) had a prior cesarean section (CS) history and the other 4 (22%) were primiparous women. Planned AIP-hysterectomy was performed in 12/18 (67%), with the remaining 6 (33%) undergoing emergent AIP-hysterectomy. Of the 6, 4 (4/6: 67%) patients were primiparous women. An intra-arterial balloon was inserted in 9/18 (50%). Women with the following three factors significantly bled less in AIP-hysterectomy than its counterpart: the employment of an intra-arterial balloon ( 4 , 448 ± 1 , 948 versus 8 , 861 ± 3 , 988 mL), planned hysterectomy ( 5 , 003 ± 2 , 057 versus 9 , 957 ± 4 , 485 mL), and prior CS ( 5 , 706 ± 2 , 727 versus 9 , 975 ± 5 , 532 mL). Patients with prior CS (−) bled more: this may be because these patients tended to undergo emergent surgery or attempted placental separation. Conclusion . Patients with intra-arterial balloon catheter insertion bled less on AIP-hysterectomy. Massive bleeding occurred in emergent AIP-hysterectomy without prior CS.
Type of Medium:
Online Resource
ISSN:
1687-9589
,
1687-9597
DOI:
10.1155/2016/5349063
Language:
English
Publisher:
Hindawi Limited
Publication Date:
2016
detail.hit.zdb_id:
2495157-2
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