COMPARISON OF EMERGENCY AND ELECTIVE HYSTERECTOMY OUTCOMES DURING AND AFTER DELIVERY AT HANOI OBSTETRICS AND GYNECOLOGY HOSPITAL
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Abstract
Objective: This study aimed to evaluate and compare maternal outcomes following emergency and elective hysterectomy performed during or after delivery at Hanoi Obstetrics and Gynecology Hospital over a five-year period (2019–2023).
Materials and method: This retrospective study comparing two surgical groups included 276 patients who underwent hysterectomy during or after delivery at Hanoi Obstetrics and Gynecology Hospital between January 1, 2019, and December 31, 2023.
Results: Subtotal hysterectomy accounted for 97.1%. Preservation of both adnexa was observed in 98.9% of cases. The mean blood loss was 1803 ±1205 ml, and the average blood transfusion was 2216 ±2285 ml, higher in the emergency hysterectomy group compared to the elective hysterectomy group (2215 ml vs. 1617 ml) (p < 0.001). The rate of intraoperative and postoperative complications was 28.6%, including bladder and ureter injuries (14.5%) and ICU admission (12.3%), mainly in cases of uterine atony and placenta accreta. The most common complications in the emergency hysterectomy group were ICU admission and bleeding requiring reoperation, while the only complication in the elective hysterectomy group was bladder and ureter injury. The surgery duration was slightly shorter in the elective hysterectomy group compared to the emergency hysterectomy group (86.1 minutes vs. 92.7 minutes) (p = 0.33).
Conclusion: Blood loss and transfusion requirements were significantly higher in the emergency hysterectomy group compared to the elective hysterectomy group. Common complications in elective hysterectomy included bladder and ureter injuries, while in emergency hysterectomy, common complications included reoperation due to intra-abdominal bleeding and ICU treatment. Surgery duration did not differ significantly between the two groups
Article Details
Keywords
Elective hysterectomy, emergency hysterectomy, placenta accreta, uterine atony
References
[2] Pettersen S, Falk RS, Vangen S, Nyfløt LT, Peripartum hysterectomy due to severe postpartum hemorrhage: A hospital‐based study. Acta Obstet Gynecol Scand, 2022;101:819–826. doi: 10.1111/aogs.14358
[3] D'Arpe S., Franceschetti S. và cộng sự, Emergency peripartum hysterectomy in a tertiary teaching hospital: a 14-year review. Archives of gynecology and obstetrics, 2015;291 (4), pp. 841-847. doi: 10.1007/s00404-014-3487-y
[4] Hoàng Thị Ngọc Trâm, Nghiên cứu các chỉ định cắt tử cung trong và sau đẻ tại bệnh viện Phụ sản Trung ương trong hai giai đoạn 2003-2004 và 2013-2014. Luận văn Thạc sỹ y học, Trường Đại học Y Hà Nội, 2015. doi: https://doi.org/10.52163/yhc.v66iCD6.2313
[5] Karen M. Flood, Soha Said, Michael Geary, Michael Robson, Christopher Fitzpatrick, Fergal D. Malone, Changing trends in peripatum hysterectomy over the last 4 decades. American Journal of Obstetrics and Gynecology, 2009; Volume 200, Isscue 6: p632. E1 – 632. E6. DOI: 10.1016/j.ajog.2009.02.001
[6] Joana Ferreira Carvalho, Adelaide Cubal, Sílvia Torres, Fernanda Costa, Olímpia do Carmo, Emergency Peripartum Hysterectomy: A 10-Year Review. International Scholarly Research Notices, 2012;vol. 2012, Article ID 721918, 7 pages,.https://doi.org/10.5402/2012/721918
[7] Ngô Minh Thắng. Nhận xét các trường hợp phẫu thuật cắt tử cung trong và sau sinh tại Bệnh viện Phụ sản Trung ương , Luận văn tốt nghiệp bác sĩ chuyên khoa cấp II, Trường Đại học Y Hà Nội, 2022.
[8] Oge T, Tokgoz VY, Cakmak Y, Velipasaoglu M. Peripartum Hysterectomy: Is There Any Difference Between Emergency and Planned Surgeries? Rev Bras Ginecol Obstet. 2022 Jan;44(1):3-9. doi: 10.1055/s-0041-1736303. Epub 2022 Jan 29. PMID: 35092953; PMCID: PMC9948102.