Factors Contributing to Massive Blood Loss on Peripartum Hysterectomy for Abnormally Invasive Placenta: Who Bleeds More?
Introduction. To identify factors that determine blood loss during peripartum hysterectomy for abnormally invasive placenta (AIP-hysterectomy). Methods. We reviewed all of the medical charts of 11,919 deliveries in a single tertiary perinatal center. We examined characteristics of AIP-hysterectomy p...
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Wiley
2016-01-01
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| Series: | Obstetrics and Gynecology International |
| Online Access: | http://dx.doi.org/10.1155/2016/5349063 |
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| author | Hironori Takahashi Akihide Ohkuchi Rie Usui Hirotada Suzuki Yosuke Baba Shigeki Matsubara |
| author_facet | Hironori Takahashi Akihide Ohkuchi Rie Usui Hirotada Suzuki Yosuke Baba Shigeki Matsubara |
| author_sort | Hironori Takahashi |
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| description | Introduction. To identify factors that determine blood loss during peripartum hysterectomy for abnormally invasive placenta (AIP-hysterectomy). Methods. We reviewed all of the medical charts of 11,919 deliveries in a single tertiary perinatal center. We examined characteristics of AIP-hysterectomy patients, with a single experienced obstetrician attending all AIP-hysterectomies and using the same technique. Results. AIP-hysterectomy was performed in 18 patients (0.15%: 18/11,919). Of the 18, 14 (78%) had a prior cesarean section (CS) history and the other 4 (22%) were primiparous women. Planned AIP-hysterectomy was performed in 12/18 (67%), with the remaining 6 (33%) undergoing emergent AIP-hysterectomy. Of the 6, 4 (4/6: 67%) patients were primiparous women. An intra-arterial balloon was inserted in 9/18 (50%). Women with the following three factors significantly bled less in AIP-hysterectomy than its counterpart: the employment of an intra-arterial balloon (4,448±1,948 versus 8,861±3,988 mL), planned hysterectomy (5,003±2,057 versus 9,957±4,485 mL), and prior CS (5,706±2,727 versus 9,975±5,532 mL). Patients with prior CS (−) bled more: this may be because these patients tended to undergo emergent surgery or attempted placental separation. Conclusion. Patients with intra-arterial balloon catheter insertion bled less on AIP-hysterectomy. Massive bleeding occurred in emergent AIP-hysterectomy without prior CS. |
| format | Article |
| id | doaj-art-565ac0d03d224536aaddaee4ac81a70c |
| institution | Kabale University |
| issn | 1687-9589 1687-9597 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
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| series | Obstetrics and Gynecology International |
| spelling | doaj-art-565ac0d03d224536aaddaee4ac81a70c2025-02-03T05:58:49ZengWileyObstetrics and Gynecology International1687-95891687-95972016-01-01201610.1155/2016/53490635349063Factors Contributing to Massive Blood Loss on Peripartum Hysterectomy for Abnormally Invasive Placenta: Who Bleeds More?Hironori Takahashi0Akihide Ohkuchi1Rie Usui2Hirotada Suzuki3Yosuke Baba4Shigeki Matsubara5Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, JapanDepartment of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, JapanDepartment of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, JapanDepartment of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, JapanDepartment of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, JapanDepartment of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, JapanIntroduction. To identify factors that determine blood loss during peripartum hysterectomy for abnormally invasive placenta (AIP-hysterectomy). Methods. We reviewed all of the medical charts of 11,919 deliveries in a single tertiary perinatal center. We examined characteristics of AIP-hysterectomy patients, with a single experienced obstetrician attending all AIP-hysterectomies and using the same technique. Results. AIP-hysterectomy was performed in 18 patients (0.15%: 18/11,919). Of the 18, 14 (78%) had a prior cesarean section (CS) history and the other 4 (22%) were primiparous women. Planned AIP-hysterectomy was performed in 12/18 (67%), with the remaining 6 (33%) undergoing emergent AIP-hysterectomy. Of the 6, 4 (4/6: 67%) patients were primiparous women. An intra-arterial balloon was inserted in 9/18 (50%). Women with the following three factors significantly bled less in AIP-hysterectomy than its counterpart: the employment of an intra-arterial balloon (4,448±1,948 versus 8,861±3,988 mL), planned hysterectomy (5,003±2,057 versus 9,957±4,485 mL), and prior CS (5,706±2,727 versus 9,975±5,532 mL). Patients with prior CS (−) bled more: this may be because these patients tended to undergo emergent surgery or attempted placental separation. Conclusion. Patients with intra-arterial balloon catheter insertion bled less on AIP-hysterectomy. Massive bleeding occurred in emergent AIP-hysterectomy without prior CS.http://dx.doi.org/10.1155/2016/5349063 |
| spellingShingle | Hironori Takahashi Akihide Ohkuchi Rie Usui Hirotada Suzuki Yosuke Baba Shigeki Matsubara Factors Contributing to Massive Blood Loss on Peripartum Hysterectomy for Abnormally Invasive Placenta: Who Bleeds More? Obstetrics and Gynecology International |
| title | Factors Contributing to Massive Blood Loss on Peripartum Hysterectomy for Abnormally Invasive Placenta: Who Bleeds More? |
| title_full | Factors Contributing to Massive Blood Loss on Peripartum Hysterectomy for Abnormally Invasive Placenta: Who Bleeds More? |
| title_fullStr | Factors Contributing to Massive Blood Loss on Peripartum Hysterectomy for Abnormally Invasive Placenta: Who Bleeds More? |
| title_full_unstemmed | Factors Contributing to Massive Blood Loss on Peripartum Hysterectomy for Abnormally Invasive Placenta: Who Bleeds More? |
| title_short | Factors Contributing to Massive Blood Loss on Peripartum Hysterectomy for Abnormally Invasive Placenta: Who Bleeds More? |
| title_sort | factors contributing to massive blood loss on peripartum hysterectomy for abnormally invasive placenta who bleeds more |
| url | http://dx.doi.org/10.1155/2016/5349063 |
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