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題 名 | Emergency Peripartum Hysterectomy due to Placenta Previa/Accreta: 10 Years' Experience |
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作 者 | Hsu,Yaw-ren; Kung,Fu-tsai; Roan,Cherng-jau; Ou,Chia-yu; Hsu,Te-yao; | 書刊名 | Taiwanese Journal of Obstetrics & Gynecology |
卷 期 | 43:4 2004.12[民93.12] |
頁 次 | 頁206-210 |
分類號 | 417.344 |
關鍵詞 | Peripartum hysterectomy; Placenta previa; Placenta accreta; Transarterial embolization; |
語 文 | 英文(English) |
英文摘要 | Objective: To identify risk factors for and sonographic findings, complications and outcomes of emergency peripartum hysterectomy due to placenta previa/accreta. Materials and Methods: This was a retrospective review and descriptive study of women who underwent emergency peripartum hysterectomy due to placenta previa/accreta at Chang Gung Memorial Hospital between 1992 and 2001 ANN emergency peripartum hysterectomies were considered by the responsible physician to be a lifesaving procedure Each chart was reviewed with emphasis on risk factors, sonographic findings, complications and outcomes. Results: There were 16 cases of emergency peripartum hysterectomy due to placenta previa/accreta (0.6/1,000 births). The mean hospitalization time was 8 days (range, 5-24 days) and the mean operation time was about 150 minutes (range, 85-335mins). The estimated mean blood loss was 3,800mL (range, 2,700-12,000mL) and the mean amount of whole blood transfused was 15 units (range, 10-38 units). Two cases of bladder injury occurred when dissecting the bladder from the lower uterine segment and cervix. Conclusions: The association of placenta previa and prior cesarean delivery with placenta accreta and emergency peripartum hysterectomy is well documented, Emergency peripartum hysterectomy remains a potentially lifesaving procedure with which every practitioner of obstetrics must be familiar. In facilities that have interventional radiological services and well-trained angiographers available on a 24-hour basis, prophylactic placement of catheters for possible selective embolization may be considered in patients with placenta previa and a prior cesarean section and sonographic findings of placenta accreta. There should be a clear, tried and tested protocol for dealing with massive obstetric hemorrhage to decrease maternal morbidity and mortality. |
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