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Ginecología y obstetricia de México
Print version ISSN 0300-9041
Abstract
REYES-HERNANDEZ, MU et al. Damage control surgery in obstetric hemorrhage: institutional experience. Ginecol. obstet. Méx. [online]. 2017, vol.85, n.1, pp.21-26. ISSN 0300-9041.
OBJECTIVE:
To evaluate the results of the damage control surgery in obstetric hemorrhage in a third level hospital.
MATERIAL AND METHOD:
Retrospective study. Medical records from patients with obstetric hemorrhage who required damage control surgery at the Obstetrics and Gynecology hospital number 3, “Centro Médico Nacional La Raza”, a third level unit in Mexico city, from January to December 2015. Measures of central tendency were performed for the statistical analysis using Software SPSS, version 16.0.
RESULTS:
16 patients were identified. The mean age of the participants was 34.5 years and for the gestational age was 33.3 weeks. The etiology of the hemorrhage included: uterine atony in 31%, abnormal placentation in 44%, uterine rupture in 13%, other causes in 13%. Planned programmed surgery was performed in 6%, while emergency surgery in 94%. The mean number of compress towels used was 7.6, and hypogastric arteries ligation was necessary in 88%. The mean time between the first and second surgeries was 27.3 hours. A definitive treatment was achieved at the second surgery in 81% of cases. The mean time of ICU stay was 5.3 days, and in hospital was 10.9 days. Complications were identified in 81% of cases, being the principal: surgical (63%), infectious (31%) and renal (81%). One death was documented.
CONCLUSIONS:
Damage control surgery should be done early by not achieving definitive control of bleeding. In obstetrics there is a high percentage of surgical complications, infectious and those resulting from massive hemorrhage.
Keywords : Damage control surgery; obstetric hemorrhage; pelvic packing.