[Ablative cesarean section and post-partum hysterectomy: review of 11 years of obstetric practice]

Abstract

Obstetric hysterectomy is often performed as an emergency life-saving procedure. This retrospective report reviews the 11 years experience (1-1 1980 through 31-12-1990) at Mangiagalli Hospital, Milan. During this time 50 obstetric hysterectomies (incidence rate = 0.12%) were performed; cesarean hysterectomies were 30 (60%), hysterectomies after cesarean section 14 (28%) and after vaginal delivery 6 (12%). Its rate during or after cesarean section was 0.44% and after vaginal delivery was 0.02%. Thirty-six per cent of patients were nulliparous. Main indications were placental disorders, uterine atony with uncontrollable bleeding, disseminated intravascular coagulation (DIC). In 7 cases was performed an elective operation, in 4 cases for neoplasia and in 3 cases for myomata uteri. Maternal mortality rate was 2.04%, five patients (10%) developed hematomas and required further interventions.