{"title":"Maharat Nakhon Ratchasima医院剖宫产子宫切除术的危险因素","authors":"Krittiya Dankhonsakul, Oraphan Aswakul","doi":"10.14456/TJOG.2017.27","DOIUrl":null,"url":null,"abstract":"Objectives: To evaluate incidence, risk factors and complications of cesarean hysterectomy. Materials and Methods: This was a retrospective case-control study. The study cases included 80 pregnant women with cesarean hysterectomy at Maharat Nakhon Ratchasima Hospital from January 1st, 2010 to December 31st, 2015. The controls referred to 320 pregnant women who underwent cesarean section at the closest time before and after the study cases. The medical records were collected and analysed. Multivariate logistic regression analysis was performed to identify risk factors. Results: During the study period, there were 50,729 deliveries and 80 pregnant women with cesarean hysterectomy (1.58:1,000). The statistically significant risk factors for cesarean hysterectomy were placenta adherent (adjusted odds ratios (AOR) 120.91, 95% confidence interval (95% CI) 22.05-1653.22), uterine atony (AOR 26.77, 95% CI 5.64-127.07), placenta previa (AOR 19.15, 95% CI 5.74-63.92), the tearing of lower uterine segment (AOR 14.92, 95% CI 4.92-45.29), multigravida (AOR 4.84, 95% CI 1.65-14.20) and emergency cesarean section (AOR 3.98, 95% CI 1.26-12.58). Hypovolemia, disseminated intravascular coagulation, postoperative fever and bladder injury were significant common complications. Conclusion: Placenta adherent, uterine atony, placenta previa, the tearing of lower uterine segment, multigravida and emergency cesarean section were identified as significant risk factors for cesarean hysterectomy.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"25 1","pages":"191-198"},"PeriodicalIF":0.0000,"publicationDate":"2017-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Risk Factors for Cesarean Hysterectomy at Maharat Nakhon Ratchasima Hospital\",\"authors\":\"Krittiya Dankhonsakul, Oraphan Aswakul\",\"doi\":\"10.14456/TJOG.2017.27\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objectives: To evaluate incidence, risk factors and complications of cesarean hysterectomy. Materials and Methods: This was a retrospective case-control study. The study cases included 80 pregnant women with cesarean hysterectomy at Maharat Nakhon Ratchasima Hospital from January 1st, 2010 to December 31st, 2015. The controls referred to 320 pregnant women who underwent cesarean section at the closest time before and after the study cases. The medical records were collected and analysed. Multivariate logistic regression analysis was performed to identify risk factors. Results: During the study period, there were 50,729 deliveries and 80 pregnant women with cesarean hysterectomy (1.58:1,000). The statistically significant risk factors for cesarean hysterectomy were placenta adherent (adjusted odds ratios (AOR) 120.91, 95% confidence interval (95% CI) 22.05-1653.22), uterine atony (AOR 26.77, 95% CI 5.64-127.07), placenta previa (AOR 19.15, 95% CI 5.74-63.92), the tearing of lower uterine segment (AOR 14.92, 95% CI 4.92-45.29), multigravida (AOR 4.84, 95% CI 1.65-14.20) and emergency cesarean section (AOR 3.98, 95% CI 1.26-12.58). Hypovolemia, disseminated intravascular coagulation, postoperative fever and bladder injury were significant common complications. Conclusion: Placenta adherent, uterine atony, placenta previa, the tearing of lower uterine segment, multigravida and emergency cesarean section were identified as significant risk factors for cesarean hysterectomy.\",\"PeriodicalId\":36742,\"journal\":{\"name\":\"Thai Journal of Obstetrics and Gynaecology\",\"volume\":\"25 1\",\"pages\":\"191-198\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2017-09-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Thai Journal of Obstetrics and Gynaecology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14456/TJOG.2017.27\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Thai Journal of Obstetrics and Gynaecology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14456/TJOG.2017.27","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的:探讨剖宫产子宫切除术的发生率、危险因素及并发症。材料与方法:本研究为回顾性病例对照研究。本研究病例包括2010年1月1日至2015年12月31日在Maharat Nakhon Ratchasima医院行剖宫产子宫切除术的孕妇80例。对照组是在研究病例前后最近时间接受剖宫产手术的320名孕妇。收集并分析了医疗记录。多因素logistic回归分析确定危险因素。结果:研究期间共分娩50,729例,剖宫产子宫切除术孕妇80例(1.58:1,000)。剖宫产子宫切除术的危险因素有胎盘贴附(调整优势比(AOR) 120.91, 95%可信区间(95% CI) 22.05 ~ 1653.22)、子宫张力(AOR 26.77, 95% CI 5.64 ~ 127.07)、前置胎盘(AOR 19.15, 95% CI 5.74 ~ 63.92)、子宫下段撕裂(AOR 14.92, 95% CI 4.92 ~ 45.29)、多胎(AOR 4.84, 95% CI 1.65 ~ 14.20)和紧急剖宫产(AOR 3.98, 95% CI 1.26 ~ 12.58)。低血容量、弥散性血管内凝血、术后发热和膀胱损伤是常见的并发症。结论:胎盘粘附、子宫张力、前置胎盘、子宫下段撕裂、多胎和急诊剖宫产是剖宫产子宫切除术的重要危险因素。
Risk Factors for Cesarean Hysterectomy at Maharat Nakhon Ratchasima Hospital
Objectives: To evaluate incidence, risk factors and complications of cesarean hysterectomy. Materials and Methods: This was a retrospective case-control study. The study cases included 80 pregnant women with cesarean hysterectomy at Maharat Nakhon Ratchasima Hospital from January 1st, 2010 to December 31st, 2015. The controls referred to 320 pregnant women who underwent cesarean section at the closest time before and after the study cases. The medical records were collected and analysed. Multivariate logistic regression analysis was performed to identify risk factors. Results: During the study period, there were 50,729 deliveries and 80 pregnant women with cesarean hysterectomy (1.58:1,000). The statistically significant risk factors for cesarean hysterectomy were placenta adherent (adjusted odds ratios (AOR) 120.91, 95% confidence interval (95% CI) 22.05-1653.22), uterine atony (AOR 26.77, 95% CI 5.64-127.07), placenta previa (AOR 19.15, 95% CI 5.74-63.92), the tearing of lower uterine segment (AOR 14.92, 95% CI 4.92-45.29), multigravida (AOR 4.84, 95% CI 1.65-14.20) and emergency cesarean section (AOR 3.98, 95% CI 1.26-12.58). Hypovolemia, disseminated intravascular coagulation, postoperative fever and bladder injury were significant common complications. Conclusion: Placenta adherent, uterine atony, placenta previa, the tearing of lower uterine segment, multigravida and emergency cesarean section were identified as significant risk factors for cesarean hysterectomy.