Original Article

Archives of Gynecology and Obstetrics

, Volume 274, Issue 2, pp 84-87

First online:

Emergency peripartum hysterectomy: a 9-year review

  • Oguz YucelAffiliated withDepartment of Obstetrics and Gynecology, Duzce School of Medicine, Abant Izzet Baysal University
  • , Ismail OzdemirAffiliated withDepartment of Obstetrics and Gynecology, Duzce School of Medicine, Abant Izzet Baysal University Email author 
  • , Nese YucelAffiliated withDepartment of Obstetrics and Gynecology, Goztepe Educational Hospital of Social Insurance Association
  • , Aslı SomunkiranAffiliated withDepartment of Obstetrics and Gynecology, Duzce School of Medicine, Abant Izzet Baysal University

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Abstract

Objective: To determine the incidence, indications, risk factors, and complications of emergency peripartum hysterectomy. Study design: A retrospective study of the patients requiring an emergency peripartum hysterectomy of a 9-year period was conducted. Emergency peripartum hysterectomy was defined as one performed for hemorrhage unresponsive to other treatment less than 24 h after delivery. Demographic and clinical variables were obtained from the maternal records. Results: There were 34 emergency peripartum hysterectomies out of 117,095 deliveries for a rate of 0.29 per 1,000. Of the 16 cases that were delivered by cesarean section, seven had a previous cesarean section and 18 cases were delivered vaginally, including two using vacuum extraction. Total hysterectomy was performed in 24 patients, and subtotal hysterectomy in ten patients. The indications for hysterectomy were uterine rupture (n=12), placenta accreta (n=10), uterine atony (n=7), and hemorrhage (n=5). There were two maternal deaths, six stillbirths, and two early neonatal deaths. Conclusion: This study identified surgical deliveries, uterine rupture, placenta accreta, and uterine atony as risk factors for emergency peripartum hysterectomy. The most common reason for abnormal placental adherence was a previous cesarean section. Multiparity and oxytocin use for uterine stimulation were among the risk factors for uterine atony that necessitated emergency peripartum hysterectomy.

Keywords

Peripartum hysterectomy Morbidity Mortality Etiologic factors