Analysis of Patients Undergoing Peripartum Hysterectomy for Obstetric Causes According to Delivery Methods: 13-Year Experience of a Tertiary Center
Yıl: 2020 Cilt: 47 Sayı: 1 Sayfa Aralığı: 122 - 129 Metin Dili: İngilizce DOI: 10.5798/dicletip.706086 İndeks Tarihi: 29-10-2020
Analysis of Patients Undergoing Peripartum Hysterectomy for Obstetric Causes According to Delivery Methods: 13-Year Experience of a Tertiary Center
Öz: Objective: The aim of this study was to examine the maternal and fetal outcomes of patients undergoing peripartumhysterectomy (PH) after vaginal delivery (VD) and cesarean section (C/S).Methods: The files of patients undergoing PH following postpartum hemorrhage (PPH) between January 2005 andNovember 2018 were reviewed retrospectively. Patients undergoing PH were divided into two groups as C/S and VD.Age, parity, gestational weeks, time between delivery and hysterectomy, estimated blood loss, duration of operation,number of blood transfusions, hospitalization time, APGAR scores of the fetus at the 1st and 5th minutes, previous C/Shistories, fetal and maternal mortality, indications for PH, additional surgeries performed during PH, and pre-op and postop complications were recorded retrospectively and the groups were compared.Results: A total of 147 patients who underwent PH for postpartum PPH were identified. Of the patients included in thestudy, 77 underwent PH after VD and 70 underwent PH after C/S. There was no statistically significant difference betweenthe groups in terms of age, parity, time between delivery and hysterectomy, estimated blood loss, number of bloodtransfusions, hospitalisation time, and maternal mortality rates. The gestational weeks of the patients in the VD groupwere higher than that of the patients in the C/S group (P = 0.003). Mean duration of operation of the C/S group was longerthan that of the VD group (P ˂ 0.001). APGAR scores of the fetus at the 1st and 5th minutes were higher in the VD groupcompared to the C/S group (P ˂0.001, P ˂0.001, respectively). The most common indication for PH was uterine atony inthe VD group (n: 54, 70.1%) and uterine rupture in the C/S group (n: 24, 34.2%). Disseminated intravascularcoagulopathy (DIC) was the most common complication in both groups. Conclusion: While fetal mortality and morbidity are higher in patients undergoing hysterectomy after C/S, long-termeffects caused by C/S (previous C/S, placenta accreta, placenta previa) increase PH risk. However, it should also beconsidered that PH risk may increase after VD as well.
Anahtar Kelime: Obstetrik Nedenlerle Peripartum Histerektomi Yapılan Hastaların Doğum Şekillerine Göre Analizi: Tersiyer Merkezin 13 Yıllık Deneyimi
Öz: Amaç: Bu çalışmada vajinal doğum (VD) sonrası ve sezaryen doğum (C/S) sonrası peripartum histerektomi (PH) uygulanan hastaların maternal ve fetal sonuçlarını incelemek amaçlandı. Yöntemler: Ocak 2005 ile Kasım 2018 tarihleri arasında tersiyer bir merkezde postpartum kanama (PPK) sonrası PH olan hastaların dosyaları retrospektif olarak incelendi. PH olan hastalar C/S sonrası ve VD sonrası olmak üzere iki gruba ayrıldı. Tüm hastaların yaşları, parite sayıları, gebelik haftaları, doğum ile histerektomi arası geçen süreleri, tahmini kan kayıpları, operasyon süreleri, kan transfüzyonu sayıları, hastanede yatış süreleri, fetüsün 1.ve 5.dakika APGAR skorları, geçirilmiş C/S öyküleri, fetal ölüm ve maternal ölüm durumları, PH endikasyonları, PH operasyonu sırasında yapılan ek cerrahiler, cerrahi sırasında veya sonrasında olan komplikasyonlar retrospektif olarak kaydedildi ve gruplar birbiri ile karşılaştırıldı. Bulgular: Doğum sonrası PPK nedeni ile PH yapılan 147 hasta tespit edildi. Çalışmaya dahil edilen hastaların 77’sine VD sonrası ve 70’ine C/S sonrası PH uygulandı. Grupların yaş, parite, doğum ile histerektomi arası geçen süreleri, tahmini kan kayıpları, yapılan kan transfüzyonu sayıları, hastanede yatış süreleri, maternal ölüm oranları arasında istatistiksel olarak fark izlenmedi. VD grubundaki hastaların gestasyonel haftaları, C/S grubundaki hastaların gestasyonel hastalarına oranla daha yüksekti (p:0.003). C/S grubunun operasyon süreleri VD grubuna göre daha uzundu (p ˂0.001). VD grubundaki hastaların bebeklerinin 1.ve 5.dakika APGAR skorları, C/S grubuna oranla daha yüksekti (sırasıyla p ˂0.001, p˂0.001). VD grubundaki hastaların en sık (n:54, %70,1) uterin atoni nedenli, C/S grubundaki hastaların ise en sık (n:24, %34,2) uterin rüptür nedenli PH olduğu görüldü. Her iki grupta da en sık görülen komplikasyonun ise dissemine intravasküler koagülopati (DİK) olduğu tespit edildi. Sonuç: C/S sonrası histerektomi olan hastalarda fetal mortalite ve morbidite daha fazla iken, C/S operasyonun neden olduğu uzun dönemli sonuçlar (geçirilmiş C/S, plasenta akreata, plasenta previa) PH riskini artırmaktadır. Ancak VD sonrası da PH riskinin artabileceği göz önünde bulundurulmalıdır.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | Peker N, Turan G, aydın e, YAVUZ M, Ege S, bademkıran m, karaçor t, GÜL T (2020). Analysis of Patients Undergoing Peripartum Hysterectomy for Obstetric Causes According to Delivery Methods: 13-Year Experience of a Tertiary Center. , 122 - 129. 10.5798/dicletip.706086 |
| Chicago | Peker Nurullah,Turan Gökçe,aydın edip,YAVUZ MUSTAFA,Ege Serhat,bademkıran muhammed hanifi,karaçor talip,GÜL TALİP Analysis of Patients Undergoing Peripartum Hysterectomy for Obstetric Causes According to Delivery Methods: 13-Year Experience of a Tertiary Center. (2020): 122 - 129. 10.5798/dicletip.706086 |
| MLA | Peker Nurullah,Turan Gökçe,aydın edip,YAVUZ MUSTAFA,Ege Serhat,bademkıran muhammed hanifi,karaçor talip,GÜL TALİP Analysis of Patients Undergoing Peripartum Hysterectomy for Obstetric Causes According to Delivery Methods: 13-Year Experience of a Tertiary Center. , 2020, ss.122 - 129. 10.5798/dicletip.706086 |
| AMA | Peker N,Turan G,aydın e,YAVUZ M,Ege S,bademkıran m,karaçor t,GÜL T Analysis of Patients Undergoing Peripartum Hysterectomy for Obstetric Causes According to Delivery Methods: 13-Year Experience of a Tertiary Center. . 2020; 122 - 129. 10.5798/dicletip.706086 |
| Vancouver | Peker N,Turan G,aydın e,YAVUZ M,Ege S,bademkıran m,karaçor t,GÜL T Analysis of Patients Undergoing Peripartum Hysterectomy for Obstetric Causes According to Delivery Methods: 13-Year Experience of a Tertiary Center. . 2020; 122 - 129. 10.5798/dicletip.706086 |
| IEEE | Peker N,Turan G,aydın e,YAVUZ M,Ege S,bademkıran m,karaçor t,GÜL T "Analysis of Patients Undergoing Peripartum Hysterectomy for Obstetric Causes According to Delivery Methods: 13-Year Experience of a Tertiary Center." , ss.122 - 129, 2020. 10.5798/dicletip.706086 |
| ISNAD | Peker, Nurullah vd. "Analysis of Patients Undergoing Peripartum Hysterectomy for Obstetric Causes According to Delivery Methods: 13-Year Experience of a Tertiary Center". (2020), 122-129. https://doi.org/10.5798/dicletip.706086 |
| APA | Peker N, Turan G, aydın e, YAVUZ M, Ege S, bademkıran m, karaçor t, GÜL T (2020). Analysis of Patients Undergoing Peripartum Hysterectomy for Obstetric Causes According to Delivery Methods: 13-Year Experience of a Tertiary Center. Dicle Tıp Dergisi, 47(1), 122 - 129. 10.5798/dicletip.706086 |
| Chicago | Peker Nurullah,Turan Gökçe,aydın edip,YAVUZ MUSTAFA,Ege Serhat,bademkıran muhammed hanifi,karaçor talip,GÜL TALİP Analysis of Patients Undergoing Peripartum Hysterectomy for Obstetric Causes According to Delivery Methods: 13-Year Experience of a Tertiary Center. Dicle Tıp Dergisi 47, no.1 (2020): 122 - 129. 10.5798/dicletip.706086 |
| MLA | Peker Nurullah,Turan Gökçe,aydın edip,YAVUZ MUSTAFA,Ege Serhat,bademkıran muhammed hanifi,karaçor talip,GÜL TALİP Analysis of Patients Undergoing Peripartum Hysterectomy for Obstetric Causes According to Delivery Methods: 13-Year Experience of a Tertiary Center. Dicle Tıp Dergisi, vol.47, no.1, 2020, ss.122 - 129. 10.5798/dicletip.706086 |
| AMA | Peker N,Turan G,aydın e,YAVUZ M,Ege S,bademkıran m,karaçor t,GÜL T Analysis of Patients Undergoing Peripartum Hysterectomy for Obstetric Causes According to Delivery Methods: 13-Year Experience of a Tertiary Center. Dicle Tıp Dergisi. 2020; 47(1): 122 - 129. 10.5798/dicletip.706086 |
| Vancouver | Peker N,Turan G,aydın e,YAVUZ M,Ege S,bademkıran m,karaçor t,GÜL T Analysis of Patients Undergoing Peripartum Hysterectomy for Obstetric Causes According to Delivery Methods: 13-Year Experience of a Tertiary Center. Dicle Tıp Dergisi. 2020; 47(1): 122 - 129. 10.5798/dicletip.706086 |
| IEEE | Peker N,Turan G,aydın e,YAVUZ M,Ege S,bademkıran m,karaçor t,GÜL T "Analysis of Patients Undergoing Peripartum Hysterectomy for Obstetric Causes According to Delivery Methods: 13-Year Experience of a Tertiary Center." Dicle Tıp Dergisi, 47, ss.122 - 129, 2020. 10.5798/dicletip.706086 |
| ISNAD | Peker, Nurullah vd. "Analysis of Patients Undergoing Peripartum Hysterectomy for Obstetric Causes According to Delivery Methods: 13-Year Experience of a Tertiary Center". Dicle Tıp Dergisi 47/1 (2020), 122-129. https://doi.org/10.5798/dicletip.706086 |
