[Obstetric hysterectomy. Review of 675 cases at the Instituto Nacional de Perinatología]

A retrospective study of 675 patients subject to obstetric hysterectomy from January 1st, 1985 to December 31st, 1995 at the Instituto Nacional de Perinatología was carried out. The incidence of this procedure reached its highest level in patients from 26 to 40 years, which represented 60.5% (409 cases) of the studied population. Patients with one previous cesarean section comprised 34.8% of total obstetric hysterectomies, followed by women with two to three previous cesarean sections (24.5% and 22.2%, respectively). As for gestational age, it reached term in 51.1% (345 cases), pre-term in 38% (257), post-term in 1.4% (10), and less than 20 weeks in 9.3% (63 cases). Main indications for obstetric hysterectomy included placenta accreta in 34.07% (230 cases), uterine atony in 32.4% (219), deciduomyometritis in 6.3% (43 cases), and uterine rupture in 4.5% (31). Most frequent complications included hypovolemia (12.1%), bladder injury (5.4%), and ureteral injury (0.7%). Postoperative complications included anemia (61.6%), febrile syndrome (7.5%), mechanic ileum (7.5%), wall abscess (3.4%), and vesicovaginal fistula (1.6%). A total of eight maternal deaths (1.1%) was reported.