ArticleCureus2020
Emergency Obstetric Hysterectomy, the Histopathological Perspective: A Cross-Sectional Study From a Tertiary Care Hospital.
Article in Cureus, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed, 5 citations in OpenAlex.
- Emergency Obstetric Hysterectomy after Conservative Management of Placenta Accreta.Case reports in obstetrics and gynecology · 2023Article
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8 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
Introduction Emergency obstetric hysterectomy (EOH) is a life-saving procedure which involves the surgical removal of uterus and is usually performed for uncontrollable maternal hemorrhage when all other conservative management has failed. This study was conducted to evaluate the histopathological findings in the EOH specimen received in the department of pathology. Methods This hospital-based cross-sectional study was conducted in the Histopathology Laboratory, Department of Pathology, and Dow Medical College (DMC) from September 2017 to December 2018. The histopathological findings in the EOH specimen were recorded and data was analyzed. Results Ninety-six cases of EOH were received. The incidence of emergency obstetric hysterectomy was 58.37/10,000 deliveries. The mean age of patients was 30.59 years (range 20-45 years). The main histopathological findings were placenta accreta spectrum in 61 (63.54%) cases, cervical tear in eight (8.33%), uterine rupture in seven (7.29%) and endomyometritis in six (6.25%) cases. In the placenta accreta spectrum, placenta accreta was the most frequent diagnosis in 23 (23.96%) of cases, placenta increta in 17 (17.71%), placenta percreta in 10 (10.42%) cases. Seven (7.29%) cases of placenta percreta and four (4.17%) cases of placenta accreta were diagnosed in association with placenta previa. Twenty placentas were received with the hysterectomies, of these eight (40%) placentas showed infarction and six (30%) had intervillous fibrin, both findings were suggestive of uteroplacental insufficiency, while three (15%) placentas had normal histology. Ovaries were received with the hysterectomies in 11 (11.46%) cases. Mature cystic teratoma was diagnosed in two (2.08%) ovaries while the majority of ovaries were normal on histology. Conclusion Placenta accreta spectrum is the leading histopathological finding in the EOH specimen. Regular antenatal follow-up and radiological examination of pregnant women is inferred to prevent obstetric complications and near-miss event of EOH. Further research is recommended to confirm the findings in placenta. Ovarian conservation is suggested in patients undergoing EOH with no clinical and surgical indication for oophorectomy.
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