Estudio de la histerectomía obstétrica como morbilidad en el Hospital América Arias en el año 2003

A retrospective, longitudinal study was performed of all patients who underwent obstetric hysterectomy in the America Arias Obstetrics and Gynecology Teaching Hospital in 2003. A thorough review of the medical records of 20 patients who underwent surgery was performed. The total number of births in the hospital during this period was 3583. Personal data, the number of cases in each age group, cause of admission, mean gestational age, obstetric history, personal pathological antecedents, mode of delivery, labor time, cesarean indication, and cause of hysterectomy were investigated. The results showed that the mean age of the patients ranged from 30 to 39 years (60%) and the mean gestational age was between 38 and 40 weeks. Most of the patients had more than three previous pregnancies, two or more deliveries, and more than two miscarriages; the most important pathological antecedent was uterine myoma. Spontaneous delivery was most common type of delivery, depending on each patient's indications, but caesarean section was the most frequent route of delivery and cephalopelvic disproportion was the most frequent indication for this procedure. The most frequent cause of obstetric hysterectomy was uterine atony. This entity had a marked influence on hospital morbidity, since it constitutes one of the most dramatic and serious situations on obstetric practice.