European journal of obstetrics, gynecology, and reproductive biology
-
Eur. J. Obstet. Gynecol. Reprod. Biol. · Dec 2010
Multicenter StudyPrediction of peripartum hysterectomy and end organ dysfunction in major obstetric haemorrhage.
The aims of this study are to determine the incidence and aetiology of major obstetric haemorrhage (MOH) in our population, to examine the success rates of medical and surgical interventions and to identify risk factors for peripartum hysterectomy and end organ dysfunction (EOD). ⋯ MOH is complicated by hysterectomy in 24% and end organ dysfunction in 16% of cases. The risk of peripartum hysterectomy is increased with the number of previous caesarean sections, the aetiology of the bleed, namely placenta praevia/accreta or uterine rupture and the volume of blood transfused. Critically, failure to maintain optimal haematocrit during the acute event was associated with end organ dysfunction.