Risk factors associated with emergency peripartum hysterectomy

作     者：JinRong Guo Yuna Chen Yan 

作者机构：Department of Obstetrics International Peace Maternity and Child Health Hospital Shanghai Jiao Tong University School of MedicineShanghai 200030 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2014年第127卷第5期

页      面：900-904页

核心收录：

学科分类：090603[农学-临床兽医学] 0817[工学-化学工程与技术] 08[工学] 09[农学] 0906[农学-兽医学] 

主　　题：emergency peripartum hysterectomy postpartumhemorrhage placenta accrete previous cesarean delivery tocolytic 

摘      要：Background Use of an emergency peripartum hysterectomy （EPH） as a lifesaving measure to manage intractable postpartum hemorrhage （PPH） appears to be increasing recently around the world,and the indications for EPH have *** object of this study is to identify risk factors associated with *** We conducted a case-control study of 21 patients who underwent EPH because of intractable PPH between January 1,2005 and June 30,2013,at the International Peace Maternity and Child Health Hospital Shanghai Jiao Tong University,School of Medicine （IPMCH）.The parametric t-test,chi-square tests and Logistic regression models were used for analysis to identify the risk *** results were considered statistically significant when P*** There were 89 178 deliveries during the study ***-one women had an EPH,with an incidence of 24 per 100 000 *** loss of blood during postpartum hemorrhage of the EPH group was （5 060.7±3 032.6）ml,and that of the control group was （2 040.8±723.5） *** was a significant difference of PHH between the EHP group and the control group （P=0.001）.Independent risk factors for EPH from a logistic regression model were：disseminated intravascular coagulation （DIC） （OR：9.9,95％ CI 2.8-34,P=0.003）,previous cesarean section （OR：5.27;95％ CI：1.48-17.9,P=0.009）,placenta previa （OR：6.9; 95％ CI 1.6-2.9,P=0.008）,the loss of PPH （OR：1.001; 95％ CI 1.001-1.002,P=0.002）,placenta accreta （OR：68; 95％ CI 10-456,P=0.004）,the use of tocolytic agents prenatally （OR：6.55,95％CI 1.34-32.1,P=0.049）,and fetal macrosomia （OR：6.9,95％ CI 1.25-38,P=0.049）.Conclusion Significant risk factors of EPH are DIC,placenta previa,PPH,previous cesarean delivery,and placenta accrete,the use of tocolytic agents prenatally,and fetal macrosomia.