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    Peripartum hysterectomy: an evolving picture.

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    Authors
    Turner, Michael J
    Affiliation
    UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, , Dublin, Ireland. michael.turner@ucd.ie
    Issue Date
    2012-02-01T10:58:38Z
    MeSH
    Female
    Humans
    Hysterectomy/*trends
    Postpartum Hemorrhage/*surgery
    Postpartum Period
    Pregnancy
    
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    Citation
    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 Obstetrics
    URI
    http://hdl.handle.net/10147/208045
    DOI
    10.1016/j.ijgo.2009.12.010
    PubMed ID
    20172521
    Abstract
    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
    eng
    ISSN
    1879-3479 (Electronic)
    0020-7292 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ijgo.2009.12.010
    Scopus Count
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    Coombe Women & Infants University Hospital

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