Clinicopathologic Correlation of the Uterus Removed for Postpartum Hemorrhage

Abstract

A retrospective clinicopathologic review of 13 women who taken postpartum hysterectomy at Ajou University Hospital during 18 months from June 1994 to Dec. 1995 is presented. The results obtained are as follows: 1) There were 2,577 deliveries during this period. 2) Postpartum hysterectomy was performed in 13 cases, an incidence of 0.5%, following 5 cases of vaginal delivery(0.3%) and 8 cases of cesarean delivery. 3) The indication for postpartum hyslerectomy were 9 cases of uterine atony(69.2%), 2 cases of placenta previa(15.4%) and 1 case of placenta accreta, 1 case of abruptio placenta, respectively. 4) The relationship of 13 postpartum hysterectomy cases between preoperative clinical indication and pathologic diagnosis were as follows : among the 9 cases of preoperative uterine atony, the pathologic diagnosis consisted of 6 cases of subinvolurion, 2 cases of placenta accreta and I case of amniotic fluid embolism. Two cases of placenta previa in preoperative indication were associated with placenta accreta in pathologic examination. Especially, one case of abruptio placenta was revealed lo be diffuse intramyometrial massive hemorrhage in pathologic diagnosis. 5) The 11 cases(84.6%) experienced postoperative complications, most common complication being febrile morbidity(41.9%) followed by disseminated intravascular coagulopathy(29.2%), superficial wound infection (12.5%) and pleural effusion(8.3%), without maternal mortality.