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Turner, Michael JAffiliation
UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, , Dublin, Ireland. michael.turner@ucd.ieIssue Date
2012-02-01T10:58:38ZMeSH
FemaleHumans
Hysterectomy/*trends
Postpartum Hemorrhage/*surgery
Postpartum Period
Pregnancy
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Int J Gynaecol Obstet. 2010 Apr;109(1):9-11. Epub 2010 Feb 20.Journal
International journal of gynaecology and obstetrics: the official organ of the, International Federation of Gynaecology and ObstetricsDOI
10.1016/j.ijgo.2009.12.010PubMed ID
20172521Abstract
Peripartum hysterectomy (PH) is one of the obstetric catastrophes. Evidence is emerging that the role of PH in modern obstetrics is evolving. Improving management of postpartum hemorrhage and newer surgical techniques should decrease PH for uterine atony. Rising levels of repeat elective cesarean deliveries should decrease PH following uterine scar rupture in labor. Increasing cesarean rates, however, have led to an increase in the number of PHs for morbidly adherent placenta. In the case of uterine atony or rupture where PH is required, a subtotal PH is often sufficient. In the case of pathological placental localization involving the cervix, however, a total hysterectomy is required. Furthermore, the involvement of other pelvic structures may prospectively make the diagnosis difficult and the surgery challenging. If resources permit, PH for pathological placental localization merits a multidisciplinary approach. Despite advances in clinical practice, it is likely that peripartum hysterectomy will be more challenging for obstetricians in the future.Language
engISSN
1879-3479 (Electronic)0020-7292 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1016/j.ijgo.2009.12.010
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