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Revista Colombiana de Obstetricia y Ginecología

Print version ISSN 0034-7434

Abstract

CASAS-PENA, Rodolfo L.; PEREZ-VARELA, Ibey Lorena  and  CHICANGANA-FIGUEROA, Gustavo A.. Frequency, indications and complications of obstetric hysterectomy at Hospital Universitario de San José in Popayán, 2006-2010: Cohort study. Rev Colomb Obstet Ginecol [online]. 2013, vol.64, n.2, pp.121-125. ISSN 0034-7434.

Objective: To determine the frequency, indications and complications of obstetric hysterectomy (OH). Materials and methods: Descriptive cohort study in patients undergoing hysterectomy for obstetric indications at Hospital Universitario San José in Popayán, Colombia, between January 1st, 2006 and May 31st, 2010. The hospital is a Level III institution offering care to uninsured poor populations as well as patients covered under the subsidized and contributive insurance regimes in the Department of Cauca and the larger southwestern region of Colombia. Consecutive sampling was used and the variables measured were: sociodemographic, gestational age; obstetric history; prior vaginal delivery or cesarean section; indication for OH; length of hospital stay; admission to the Intensive Care Unit (ICU); need for transfusion; complications and maternal and perinatal mortality. Results are presented in proportion terms. Results: A total of 49 OH were performed. Over the same period, 8,167 obstetric patients were admitted. The hysterectomy incidence was 5.9 per 1000 births. The most frequent indications were uterine atony (43.37%) and placental insertion abnormalities (18.24%); perinatal mortality was high at 32.6%, anemia was the most frequent complication (76.3%) and there were no cases of maternal mortality Conclusions: The main indication for OH was uterine atony, followed by placental insertion abnormalities, uterine rupture, myometritis, abruptio placentae and septic miscarriage. OH represents a safe and timely management option for post-partum bleeding that does not respond to conventional pharmacological or surgical treatment.

Keywords : Hysterectomy; bleeding; placenta accreta.

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