Retrospektywna analiza operacji okołoporodowego wycięcia macicy

Retrospektywnej ocenie poddano 32 przypadki okołoporodowego wycięcia macicy przeprowadzone w latach 1997–2005 w Szpitalu Wojewódzkim nr 2 w Rzeszowie. W analizie uwzględniono wskazania do zabiegu, sposób zakończenia ciąży, czas hospitalizacji oraz powikłania pooperacyjne. Stwierdzono, że najczęstszą przyczyną okołoporodowego wycięcia macicy były krwotoki spowodowane atonią macicy oraz stany zapalne narządu rodnego. Zwrócono uwagę na wysoki odsetek powikłań związanych z tą operacją.


Objectives: Peripartum hysterectomy is a treatment applied in heavy post delivery bleedings. Main reasons for this treatment are atonia of uterus and pathological implantation of placenta. Planned hysterectomy before cesarean section is performed as a part of surgical treatment of cervical cancer for pregnant women.
Design: The aim of the study is to present own experiencies with peripartum hysterectomy.
Materials and methods: Medical data of patients who underwent peripartum hysterectomy in 1997-2005 was analised in the retrospective study. Particular attention was paid to: the way pregnancy terminated, indication to hysterectomy and perioperative complications.
Results: In the period mention above at the Gynecological and Obstetric Ward in District Hospital No 2 in Rzeszów there were 21589 deliveries. 32 peripartum hysterectomies were performed in this group. The main indication was atonia of uterus (37.5%). Peripartum hysterectomy was rarely performed because of pelvic inflammatory disease, patho- logical implantation of placenta and caogulopathies. Percentage of complications was 31.25%.
Conclusions: Peripartum hystere- ctomy in heavy bleeding after deliveries is an emergency preocedure. It should be applied immidietaly when pharmaco- logical and conservative treatment do not bring required effect.