Histerectomia puerperal em um hospital maternidade de alto risco na Amazônia

Leticia Porto Picanço; Geórgia Helena dos Santos Tamer; Cynthia Mara Brito Lins Pereira; Vitor Hugo Freitas Gomes

doi:10.23925/1984-1840.2024v26a26

Authors

Leticia Porto Picanço Fundação Santa Casa de Misericórdia do Pará
Geórgia Helena dos Santos Tamer Fundação Santa Casa de Misericórdia do Pará
Cynthia Mara Brito Lins Pereira Universidade Federal do Pará (UFPA)
Vitor Hugo Freitas Gomes Centro Universitário do Pará (CESUPA)

DOI:

https://doi.org/10.23925/1984-1840.2024v26a26

Keywords:

Hysterectomy, Postpartum hemorrhage, Puerperal infection

Abstract

Objective: To describe the clinical and epidemiological profile of patients undergoing puerperal hysterectomy (PH) at the Fundação Santa Casa de Misericórdia do Pará (FSCMP), a reference hospital of the Northern Region for high-complexity maternal and child care. Materials and Methods: A retrospective, observational and descriptive study
was conducted on the electronic medical records of patients who underwent PH between January 2020 and December 2022 at the FSCMP. Results: 94 PH were performed over three years, with a rate of 3.97 PH per 1,000 births. The mean age of the patients was 30 years-old. The most common educational level was complete high school (49%), and the majority were single (51%). Nearly 40% of the patients had four or more pregnancies, and 36% had three or more previous deliveries. The most frequent route of delivery was cesarean section (91%). The main reasons for PH were refractory uterine atony and pelvic sepsis. Regarding the surgical technique, total abdominal hysterectomy was the majority (56%). In 60% blood transfusion was required, and 73% of cases required ICU care. The mean mortality rate
was 3.1 deaths per 100 PH. Conclusion: The incidence of PH at the FSCMP was high. Most patients were multiparous with one or more previous cesarean deliveries and the route of delivery of the current pregnancy was cesarean section. A large portion required ICU care and blood component transfusions. The mortality rate for PH at the research institution was lower than found in the literature.

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