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Obstet Gynecol Sci > Volume 55(12); 2012 > Article
Korean Journal of Obstetrics & Gynecology 2012;55(12):901-906.
DOI: https://doi.org/10.5468/KJOG.2012.55.12.901    Published online December 18, 2012.
Prognosis and indication of emergency hysterectomy following postpartum hemorrhage.
Jung Mi Byun, Young Nam Kim, Dae Hoon Jeong, Young Jin Seo, Eun Jeong Jeong, Ji Young Kang, Moon Su Sung, Kyung Bok Lee, Ki Tae Kim
1Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. hellojungmi@hanmail.net
2Paik Institute for Clinical Research, Inje University, Busan, Korea.
3Department of Obstetrics and Gynecology, Dong-A University College of Medicine, Busan, Korea.
Abstract
OBJECTIVE
To compare the clinical characteristics and the prognosis between emergency hysterectomy and conservative treatment following postpartum hemorrhage. METHODS: Primary postpartum hemorrhage was identified in 68 patients who treated in our hospital after delivery at Inje University Busan Paik Hospital and local hospital between 2004 and 2011. 29 patients of these were performed emergency hysterectomy and 39 patients conserved uterus. Clinical characteristics and prognosis of postpartum hemorrhage were reviewed and analyzed with medical records. RESULTS: There were no difference of mean age, body mass index, parity, causes of postpartum hemorrhage (PPH), and labor induction between hysterectomy and conservative treatment. The hysterectomy patients had lower blood pressure (83.62/48.01 mm Hg +/- 19.16/21.68 mm Hg vs. 96.10/64.12 mm Hg +/-16.17/22.8 mm Hg), higher heart rate (114 +/- 21.68/min vs. 96.10 +/- 22.8/min), and lower hemoglobin concentration (6.99 +/- 3.06 g/dL vs. 8.34 +/- 2.1 g/dL) than the patients with conservative treatment (P=0.0007, 0.0017, 0.0358, respectively). Hysterectomy group had a longer hospital stay, much more management in intensive care unit (ICU) and more complications than conservative group (P=0.0004, <0.0001, 0.0049, respectively). CONCLUSION: If patients with postpartum hemorrhage were hemodynamically unstable, it is more possible to be performed the emergency hysterectomy. Emergency hysterectomy was associated with a longer hospital stay and more complications. Therefore we consider that early recognition of PPH with frequent monitoring of vital sign, uterine contraction and vaginal bleeding is able to reduce unnecessary hysterectomy and minimize potentially serious outcomes.
Key Words: Postpartum hemorrhage, Hysterectomy, Conservative treatment


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