Hysterectomy Obstetrical Emergency In The Regional Hospital Of West: Impact And Associated Factors

Abstract

Obstetrical hysterectomy emergency (OH) is partial or total resection of the uterus, done as unscheduled complications of pregnancy, childbirth and postpartum or pre-existing disease complications. The objective of the study was determine the incidence, clinical characteristics, causes, and complications of the OH in patients attended of ginecoobstetrical service of Hospital Regional de Occidente in Santa Rosa de Copan Honduras in the years 2005-2009. We performed a descriptive observational research, retrospective type cohort retrospective. The frecuency of OH in the five years was 0.11% in total 36 OH in 31,898 obstetric events. The relevant obstetric characteristics were: 72% of patients had history of caesarean section, in 56% of the cases was practice a caesarean - hysterectomy, 62% of the OH in the postpartum period was consecuence for caesarean section, the risk of HO in caesarean section vrs. childbirth was OR 11.78 (4.78 - 29.76), 95%, p 0.00000000, the three main directions were uterine rupture, uterine atony and placental accreta; 64% of patients had been manipulate by a physician before to admission to the hospital; multíparous over 50% of cases; 53% without prenatal care; half of the cases consumed four units of blood or more; the most frequent complications were anaemia; respiratory infection, urinary track injury and the lethality was 6 per cent, less than that observed in other Latin American countries.