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Open Access
CC BY 4.0 · Rev Bras Ginecol Obstet 2022; 44(01): 003-009
DOI: 10.1055/s-0041-1736303
Original Article
Obstetrics

Peripartum Hysterectomy: Is There Any Difference Between Emergency and Planned Surgeries?

Histerectomia periparto: Existe alguma diferença entre as cirurgias de emergência e planejada?
Tufan Oge 
1   Department of Obstetrics and Gynecology, School of of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
,
Vehbi Yavuz Tokgoz 
1   Department of Obstetrics and Gynecology, School of of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
,
Yusuf Cakmak 
1   Department of Obstetrics and Gynecology, School of of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
,
Melih Velipasaoglu 
1   Department of Obstetrics and Gynecology, School of of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
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Abstract

Objective To compare the outcomes of emergency and planned peripartum hysterectomies.

Methods The present retrospective cross-sectional study was conducted in two hospitals. Maternal and neonatal outcomes were compared according to emergency and planned peripartum hysterectomies.

Results A total of 34,020 deliveries were evaluated retrospectively, and 66 cases of peripartum hysterectomy were analyzed. Of these, 31 were cases of planned surgery, and 35 were cases of emergency surgery. The patients who underwent planned peripartum hysterectomy had a lower rate of blood transfusion (83.9% versus 100%; p = 0.014), and higher postoperative hemoglobin levels (9.9 ± 1.3 versus 8.3 ± 1.3; p < 0.001) compared with the emergency hysterectomy group. The birth weight was lower, although the appearance, pulse, grimace, activity, and respiration (Apgar) scores were higher in the planned surgery group compared with the emergency cases.

Conclusion Planned peripartum hysterectomy with an experienced team results in less need for transfusion and improved neonatal outcomes compared with emergency peripartum hysterectomy.

Resumo

Objetivo Comparar os resultados das histerectomias periparto de emergência e planejada.

Métodos Este estudo transversal retrospectivo foi realizado em dois hospitais. Os resultados maternos e neonatais foram comparados de acordo com as histerectomias periparto de emergência e planejada.

Resultados Um total de 34.020 partos foram avaliados retrospectivamente, e 66 casos de histerectomia periparto foram analisados. Destes, 31 eram casos de cirurgias planejadas, e 35, cirurgias de emergência. As pacientes que foram submetidas à histerectomia periparto planejada tiveram uma taxa menor de transfusão de sangue (83,9% versus 100%; p = 0,014), e níveis mais elevados de hemoglobina pós-operatória (9,9 ± 1,3 versus 8,3 ± 1,3; p < 0,001) em comparação com o grupo de histerectomia de emergência. O peso ao nascer foi menor, embora as pontuações na escala de aparência, frequência cardíaca, irritabilidade reflexa, tônus muscular, e respiração (appearance, pulse, grimace, activity, and respiration, Apgar, em inglês) fossem maiores no grupo da cirurgia planejada em comparação com os casos de emergência.

Conclusão A histerectomia periparto planejada com uma equipe experiente resulta em menos necessidade de transfusão e melhora os resultados neonatais em relação à histerectomia periparto de emergência.

Keywords

abnormal placentation - emergency - peripartum hysterectomy - planned - uterine atony

Palavras-chave

placentação anormal - de emergência - histerectomia periparto - planejada - atonia uterina

Contributors

All authors participated in the concept and design of the study, as well as in the analysis and interpretation of data, draft or revision of the manuscript, and they have approved the manuscript as submitted. All authors are responsible for the reported research.




Publication History

Received: 21 February 2020

Accepted: 09 August 2021

Article published online:
29 January 2022

© 2022. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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