Clinical Analysis Of70Cases Of Obstetric Hysterectomy

Objective: Study on related factors of obstetric hysterectomy,toinvestigate the method of decreasing the incidence of obstetrichysterectomy.Methods: A retrospective study of70cases of obstetric hysterectomyin the first affiliated hospital of Chongqing Medical University from May2004to May2011were analyzed. The binary logistic regression was usedin the analysis of risk factors.Results:70cases of obstetric hysterectomy were identified among25932deliveries，including13cases delivered in other hospital andtransferred to our hospital performed hysterectomy.The incidence ofobstetric hysterectomy was2.20‰(57/25932).66cases(94.3%)weredelivered by cesarean section, and4cases(5.7%)were delivered vaginal.Total hysterectomy was performed in17cases, subtotal in53cases. Themain indications of obstetric hysterectomy were placentafactors(52.9%),uterine agony(17.1%)and infection of uterineincision(12.9%). There were7factors associated with obstetrichysterectomy significantly according to the single factor analysis and4factors entered the logistic regression model according to the multiple factors analysis. Multivariate analysis revealed that placenta increta(OR=27.258,95%CI=22.534～29.269), placenta previa (OR=21.293,95%CI=18.259～22.006), history of cesareansection(OR=3.58795%,CI=2.589～19.557) and uterine agony(OR=1.857,95%CI=1.302～2.530) were independent risk factors forobstetric hysterectomy.Conclusion: The major reasons and indications of obstetrichysterectomy are placental factors and uterine atony. Hysterectomy is one ofthe effective methods on arresting severe postpartum hemorrhage, which isadvised to improve pregnant monitoring and to advocate family planning,and to master the indication of cesarean section, and to train the obstetricaldoctors appropriately, and to find a right time to cut the uterus can efficientlyreduce the incidence of obstetric hysterectomy.