The Analysis Of 23 Cases Of Placental Abruption Leading To Hysterectomy

Objective:Analysis of obstetric hysterectomy and correct the indications of the reasons. Hysterectomy is the treatment of acute obstetric uterine bleeding, rescue the life of pregnant women to take an effective treatment measures, Obstetric hysterectomy is a clinic for severe obstetric hemorrhage through other methods (such as medicines, massage the uterus, uterine artery ligation, uterine packing gauze, etc.) ineffective treatment for life-saving maternal and effective measures. As pregnant women young, after the loss of fertility, while the loss of timing of surgery can also cause deaths, so the need to strictly control surgical indications early and accurate decision on timely implementation of the operation.Methods:Retrospective analysis of 10 years in our hospital 23 cases of ineffective conservative treatment after a positive patients with postpartum hemorrhage an emergency hysterectomy, sum up the specific reasons for obstetric hysterectomy. Now in our hospital in January 1999 June 2009 delivery of 16,244 cases, because of placental abruption-line analysis of 23 cases of hysterectomy, In which to give birth in our hospital 18 cases of maternal line of hysterectomy, accounting for total number of deliveries of 0.11%,11 cases in which vaginal delivery, accounting for 61.11%, cesarean section in 5 cases, accounting for 27.78 percent, medium-term abortion in 2 cases, accounting for 11.11%.. Outside the hospital emergency hysterectomy due to placental abruption into the line in 5 cases.Results:Placental factor is the build-line post-partum bleeding, emergency hysterectomy in the main indications. A great impact on maternal and infant prognosis of placental abruption, so, once diagnosed, should be actively treated, correct shock, and timely termination of pregnancy, fetal survival fight and reduce complications. Mode of delivery should be based on the severity of maternal illness, fetal status, birth process, production type, and so decided to. If the mothers in general in good condition, cervix, estimated to bring an end to birth a short time, could in the intensive care under the vaginal trial production, opening its mouth as soon as the Palace of vaginal delivery. For this stage a light but there are fetal distress, placental abruption and severe placental abruption, a short time can not be the end of maternity leave, regardless of whether the fetus to survive, should be give cesarean section delivery as soon as possible in order to improve perinatal survival, in order to avoid uteroplacental apo-plexy. Early diagnosis can reduce the incidence of uteroplacental apoplexy. If it has occurred, surgery to remove the baby, placenta im-mediately after application of contraction agents, quickly suture the uterine incision in order to maintain its integrity, with hot saline gauze wet packing, massage the uterus to promote contraction, reduce bleeding. If the uterus color to red, bleeding much, it can keep the uterus, if after the above treatment, the uterus continued to show a purple blue, pocket does not shrink more than the amount of bleeding should be transfusion, blood transfusion to save shock at the same time decisive line of hysterectomy surgery. Hysterectomy surgery is not only consistent with secretion and women's physical, psychological demands, but also surgical simple, fast bleeding, less bleed-ing, the operator easy to master, and due to emergency surgery, vaginal preparations inadequate hysterectomy easily lead to postoperative infection. But for amniotic fluid embolism, uterine rupture involving the cervix were in full hysterectomy is appropriate, Congestion and edema are often due to uterine rupture after the anatomical structures is unclear, surgery should be carefully separated, Ureter and bladder to avoid injury, pay attention to rigorous disinfection of stump suture, hemostasis should be thorough and must not be taken lightly.Conclusions:Birth process and obstetrics complication were treated correctly,the rate of cesarean section were reduced effectively,all this can help to decrease the incidence of obstetric hysterectomy.