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Objective: To analyze the reasons for obstetric hysterectomy and correctly grasp the indications. Hysterectomy is to save maternal life, treatment of acute obstetric bleeding while taking an effective treatment measures, obstetric hysterectomy is used clinically severe obstetric hemorrhage but through other means (such as drugs, massage the uterus, uterine packing gauze , uterine artery ligation, etc.) therapy, an effective rescue measures for maternal life. As pregnant women young patients will lose reproductive ability, and timing of surgery can also lead to loss of patient death, it should be strictly controlled indications for surgery as soon as possible to make decisions timely and accurate implementation of the operation. Methods: A retrospective analysis of our hospital 10 years 23 patients with active conservative treatment fails postpartum hemorrhage underwent emergency hysterectomy, summarize the specific reasons for obstetric hysterectomy. Pital January 1999 - June 2009 16,244 cases of childbirth, hysterectomy due to placental abruption analyzed 23 cases in which the delivery of maternal hospital hysterectomy in 18 cases, accounting for 0.11% of total number of deliveries, including cesarean section 5 cases, 27.78%, vaginal delivery in 11 cases, accounting for 61.11%, medium-abortion two cases, accounting for 11.11%. Outside the hospital emergency hysterectomy due to placental transfer five cases. Results: The placenta is caused by postpartum hemorrhage and the line of the main emergency hysterectomy. Abruption great impact on maternal and child outcomes, so once diagnosed, should be actively treated, correct shock, timely termination of pregnancy, for fetal survival and reduce complications. Mode of delivery should be based on the severity of pregnant women, birth process, production style, fetal status decision. If maternal general condition is good, cervix, estimated delivery within a short time will be able to end, in intensive care vaginal trial production cervix after vaginal delivery as soon as possible. But there is light for fetal distress, placental abruption and heavy, short time can not end delivery, regardless of fetal survival or not, should end as soon as cesarean delivery, in order to improve perinatal survival, avoid the uterus placenta stroke. Early diagnosis can reduce the incidence of uteroplacental apoplexy. If occurs, surgery to remove the fetus, the placenta immediately after application uterotonic, rapid repair of the uterine incision to maintain its integrity, with hot saline wet gauze pad, massage the uterus to promote its contraction, reduce bleeding. If the uterus color to red, bleeding much, it can keep the uterus, such as the above treatment, the uterus continued to show a purple-blue, baggy does not shrink, bleeding still many in the infusion, transfusion rescue shock at the same time decisive subtotal hysterectomy surgery. Hysterectomy surgery not only to women secretion and psychological, physical requirements, and simple surgical procedures, bleeding fast, less bleeding, the operator easy to master, but as emergency surgery, vaginal inadequate preparation, hysterectomy could easily lead to postoperative infection . But for uterine rupture involving the cervix, amniotic fluid embolism should be appropriate to hysterectomy, the uterus often edema and congestion, rupture unclear anatomy, surgery must be carefully separated to avoid damage to the bladder and ureter. Note stump should be strictly sterilized suture hemostasis more thoroughly, must not to be taken lightly. Conclusion: Positive correct handling of labor and obstetric complications strictly cesarean section, reduce the cesarean section rate, thereby reducing the incidence of obstetric hysterectomy.
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