[Obstetric hysterectomy]. / Okoloporodowe wyciecie macicy.

ABSTRACT

UNLABELLED An analysis of indications for obstetric hysterectomy in Central Teaching Hospital of Ministry of Internal Affairs in Warsaw between 1985-1997 is presented. There have been 15 caesarean or post partum hysterectomies over that period, which makes 0.11% of all deliveries and 0.67% of caesarean sections. All operations followed caesarean sections. In two patients (13.3%) procedure was performed electively because of myomas. In the remainder emergency or post-partum hysterectomy was necessary. The most common indication was haemorrhage connected with placenta praevia, adherent placenta and abruption of placenta (53.3%). Other indications included ruptured uterus (6.7%), severe postpartum or intrapartum haemorrhage due to uterine atony (20.0%) and HELLP syndrome (6.7%). CONCLUSION: 1. Complications associated with pathologies of placenta are the most common indication for obstetric hysterectomy in our study. 2. Patients that are mostly exposed to the risk of obstetric hysterectomy are multiparous women especially with previous caesarean section. 3. The incidence of obstetric hysterectomy seems to be rising, possibly as a consequence of the rising rate of caesarean section and uterine curretage.