THE INCIDENCE OF PERIPARTAL HYSTERECTOMY IN FIVE CROATIAN HOSPITALS DURING SIXTEEN-YEAR PERIOD

Uvod: Peripartalna histerektomija (PPH) najdramatičniji je kirurški zahvat u modernoj opstetriciji i obično se obavlja kada se konzervativnim mjerama nije uspjela postići kontrola krvarenja. Navodi se trend porasta učestalosti u razvijenim zemljama. Cilj rada: Odrediti učestalost PPH u pet hrvatskih bolnica tijekom dvaju osmogodišnjih razdoblja u odnosu prema načinu dovršenja porođaja. Metode: Retrospektivnom analizom prikupljeni su podaci iz pismohrana pet hrvatskih bolnica. U istraživanje su uključeni svi porođaji podijeljeni u dva osmogodišnja razdoblja, od 1998. do 2013. Rezultati: Od ukupno 153.302 porođaja tijekom obaju promatranih razdoblja u 70 (0,46‰) slučajeva učinjen je hitni PPH. PPH nakon vaginalnog porođaja u prvom razdoblju iznosio je 0,21‰, a u drugom razdoblju 0,16‰. Učestalost PPH nakon carskog reza u prvom razdoblju iznosio je 1,91‰, a u drugom razdoblju 2,04‰. Rasprava i zaključak: Nema porasta pojavnosti PPH usporedbom dvaju osmogodišnjih razdoblja premda postoji statistički značajan porast učestalosti carskog reza (s 14,2% na 16,0%). Carski je rez čimbenik rizika za PPHIntroduction: Peripartal hysterectomy (PPH) is a life saving surgical procedure that is performed when conservative measures fail to control bleeding. According to literature data there is an increase in incidence among developed countries. Aim: To define the rate of PPH during two eight-year periods in five Croatian hospitals in respect to mode of delivery. Methods: Patients data were collected retrospectively from the medical records of the five Croatian hospitals. We analyzed data from 1998 to 2013, and divided them in two eight-year periods. Results: In 70 cases out of 153,302 deliveries urgent PPH was performed. PPH after vaginal deliveries was found in 0.21‰ and 0.16‰ and PPH after caesarean section was 1.91‰ and 2.04‰ in the first and second period, respectively. Discussion and conclusion: There is no increase of PPH rate in the two analyzed periods, although there is a statistically significant increase of caesarean section rate. Caesarean section presents higher risk for PPH

THE INCIDENCE OF PERIPARTAL HYSTERECTOMY IN FIVE CROATIAN HOSPITALS DURING SIXTEEN-YEAR PERIOD

Uvod: Peripartalna histerektomija (PPH) najdramatičniji je kirurški zahvat u modernoj opstetriciji i obično se obavlja kada se konzervativnim mjerama nije uspjela postići kontrola krvarenja. Navodi se trend porasta učestalosti u razvijenim zemljama. Cilj rada: Odrediti učestalost PPH u pet hrvatskih bolnica tijekom dvaju osmogodišnjih razdoblja u odnosu prema načinu dovršenja porođaja. Metode: Retrospektivnom analizom prikupljeni su podaci iz pismohrana pet hrvatskih bolnica. U istraživanje su uključeni svi porođaji podijeljeni u dva osmogodišnja razdoblja, od 1998. do 2013. Rezultati: Od ukupno 153.302 porođaja tijekom obaju promatranih razdoblja u 70 (0,46‰) slučajeva učinjen je hitni PPH. PPH nakon vaginalnog porođaja u prvom razdoblju iznosio je 0,21‰, a u drugom razdoblju 0,16‰. Učestalost PPH nakon carskog reza u prvom razdoblju iznosio je 1,91‰, a u drugom razdoblju 2,04‰. Rasprava i zaključak: Nema porasta pojavnosti PPH usporedbom dvaju osmogodišnjih razdoblja premda postoji statistički značajan porast učestalosti carskog reza (s 14,2% na 16,0%). Carski je rez čimbenik rizika za PPHIntroduction: Peripartal hysterectomy (PPH) is a life saving surgical procedure that is performed when conservative measures fail to control bleeding. According to literature data there is an increase in incidence among developed countries. Aim: To define the rate of PPH during two eight-year periods in five Croatian hospitals in respect to mode of delivery. Methods: Patients data were collected retrospectively from the medical records of the five Croatian hospitals. We analyzed data from 1998 to 2013, and divided them in two eight-year periods. Results: In 70 cases out of 153,302 deliveries urgent PPH was performed. PPH after vaginal deliveries was found in 0.21‰ and 0.16‰ and PPH after caesarean section was 1.91‰ and 2.04‰ in the first and second period, respectively. Discussion and conclusion: There is no increase of PPH rate in the two analyzed periods, although there is a statistically significant increase of caesarean section rate. Caesarean section presents higher risk for PPH