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  • Title: [Postoperative infection as an indication for hysterectomy after cesarean section].
    Author: Milasinović L, Cetković N, Radeka G, Bingold B, Petrović D, Orelj M.
    Journal: Med Pregl; 1996; 49(5-6):221-4. PubMed ID: 8692100.
    Abstract:
    Even today infection is the most important cause of morbidity and mortality after cesarean section. The aim of this paper is to point to the significance of hysterectomy in treatment of puerperal infection in the contemporary obstetrics. During a 15- year period (1981 - 1995) 85231 deliveries were performed at the Clinic for Gynecology and Obstetrics in Novi Sad (Yugoslavia). There were 8609 (10.10%) cesarean sections. Hysterectomy was performed in 16 cases (0.186%) of women undergoing cesarean section due to dehiscence of uterine suture, endometritis, diffuse peritonitis or sepsis. Infection during delivery was diagnosed in 3 (18.75%) cases, the delivery itself began by amnion rupture in 5 (31.25%) cases, it lasted more than 12 hours in 6 (37.50%) cases. Elective cesarean section was performed in 3 (18.75%) cases, cesarean section during delivery in 13 (81.25%) and iterative cesarean section in 5 (31.25%) cases. Total hysterectomy was performed in 9 (56.25%) cases and subtotal in 7 (43.75%) cases. Postoperative treatment by antibiotics was carried out in all cases. There were postoperative complications after hysterectomy in 7 (43.75%) cases. According to results of microbiologic analyses in 7 (43.75%) cases one cause was determined, while in 9 (56.25%) cases two or more causes were determined. Gram-negative-bacteria were the most common cause (68.75%).
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