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- W2068643988 abstract "Major obstetric hemorrhage (MOH) is a life threatening obstetric complication accounting for 8% of maternal deaths in developed countries. It can require surgical intervention which often compromises future fertility. We sought to examine the influence of age and parity on rates of peripartum hysterectomy (PH) compared to fertility sparing techniques. This is a review of all cases of major obstetric hemorrhage (>5 units red cell concentrate) over 5 years between 2005 and 2009 in three large tertiary hospital. All have comparable rates of maternal morbidity and mortality. Variables recorded included patient characteristics, rate of blood product administration as well as surgical interventions. During the study period there were 122,653 mothers who delivered between the three hospitals. There were 167 cases of MOH over the study period giving an incidence of 1.4/1,000. 82 (49.1%) had a laparotomy, 38 (23%) underwent PH. Internal Iliac artery ligation was performed in 18 (11%) and B-Lynch suture in 5 (3%). The number of units of red cell concentrate increased with increasing maternal age (p=0.006) with a mean of 9.5 in multiparas compared to 7.6 in nulliparas (p=0.005). The mean age of patients was 32.2 years +/−5.5. The mean age of patients undergoing PH was significantly higher than those who did not (35.1 vs 31.5 years ; p=0.002) as was the mean age of those undergoing laparotomy (33.5 vs 30.9 years ; p=0.003). No significant difference was noted in the mean age of those requiring B-Lynch suture, internal iliac ligation or insertion of intrauterine balloon. Of the study group 68 patients (41%) were primiparous and 99 (59%) patients were multiparous. PH was more likely in multiparous patients 25/99 (25%) vs. 2/68 (3%) (p<0.001). Maternal age and parity are significant risk factors for major obstetric haemorrhage. When surgical intervention is required, fertility sparing techniques are less likely to be used in older multiparous patients. This may in part reflected the influence of patient characteristics in the decision making process at the time of surgery." @default.
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- W2068643988 date "2012-01-01" @default.
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- W2068643988 title "120: Impact of maternal age and parity in management and outcome of major obstetric haemorrhage" @default.
- W2068643988 doi "https://doi.org/10.1016/j.ajog.2011.10.138" @default.
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