Emergency peripartum hysterectomy
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
To determine the incidence, indications, risk factors and complications of peripartum hysterectomy in a tertiary teaching hospital.
The medical records of 73 patients who had undergone emergency peripartum hysterectomy between 2003 and 2008 were reviewed retrospectively. Maternal characteristics and characteristics of the present pregnancy and delivery, hysterectomy indications, operative complications, postoperative conditions and maternal outcomes were evaluated.
There were 73 emergency peripartum hysterectomies out of 114,720 deliveries, a rate of 0.63 per 1,000 deliveries. Eleven hysterectomies were performed after vaginal delivery (0.12/1,000 vaginal deliveries) and the remaining 62 hysterectomies were performed after cesarean section (2/1,000 cesarean sections). The most common indication for hysterectomy was placenta previa and/or accreta (31 patients, 42.4%), followed by uterine atony (26 patients, 35.6%). In this study, 22 of 29 patients (75.8%) with placenta previa and 12 of 16 patients (75%) with placenta accreta had previously had cesarean sections. Cesarean section is associated with placenta previa and accreta, which are the most common causes of emergency peripartum hysterectomy.
The increase in the cesarean delivery rate is leading to an increase in the rate of abnormal placentation (placenta previa and accreta), which in turn give rise to an increase in the peripartum hysterectomy rate. Cesarean section itself is also a risk factor for emergency peripartum hysterectomy. Therefore, every effort should be made to reduce the cesarean rate by performing this procedure only for valid clinical indications. The risk factors for peripartum hysterectomy should be identified antenatally. The delivery and operation should be performed in appropriate clinical settings by experienced surgeons when risk factors are identified.
- Waterstone M, Bewley S, Wolfe C (2001) Incidence and predictors of severe obstetric morbidity: case–control study. BMJ. 322(7294):1089–1093 CrossRef
- Hall M (2004) Haemorrghage. In: Why mothers die: report on confidential enquiries into maternal deaths in the United Kingdom 2002–2004. RCOG Press, London (UK), pp 86–95
- Mousa HA, Walkinshaw S (2001) Major postpartum haemorrhage. Curr Opin Obstet Gynecol 13(6):595–603 (Review) CrossRef
- Hall M (2004) Haemorrhage. In: Why mothers die 2000–2002. Royal College of Obstetricians and Gynecologists, London (UK), pp 86–93
- Smith J, Mousa HA (2007) Peripartum hysterectomy for primary postpartum haemorrhage: incidence and maternal morbidity. J Obstet Gynaecol 27(1):44–47 CrossRef
- Sakse A, Weber T, Nickelsen C, Secher NJ (2007) Peripartum hysterectomy in Denmark 1995–2004. Acta Obstet Gynecol 86:1472–1475 CrossRef
- Bai SW, Lee HJ, Cho JS, Park YW, Kim SK, Park KH (2003) Peripartum hysterectomy and associated factors. J Reprod Med 48(3):148–152
- Zeteroglu S, Ustun Y, Engin-Ustun Y, Sahin G, Kamaci M (2005) Peripartum hysterectomy in a teaching hospital in the eastern region of Turkey. Eur J Obstet Gynecol Reprod Biol 120(1):57–62 CrossRef
- Glaze S, Ekwalanga P, Roberts G et al (2008) Peripartum hysterectomy: 1999 to 2006. Obstet Gynecol 111(3):732–738 CrossRef
- Porro E (1876) Dell’ amputazione utero-ovarica come complemento di taglio cesareo. Ann Univ Med Chir 237–289 (cited by Durfee RB: evolution of cesarean hysterectomy (1969) Clin Obstet Gynecol 12:575–589)
- Kwee A, Bots ML, Visser GH, Bruinse HW (2006) Emergency peripartum hysterectomy: a prospective study in the Netherlands. Eur J Obstet Gynecol Reprod Biol 124(2):187–192 CrossRef
- Zorlu CG, Turan C, Işik AZ, Danişman N, Mungan T, Gökmen O (1998) Emergency hysterectomy in modern obstetric practice changing clinical perspective in time. Acta Obstet Gynecol Scand 77(2):186–190 CrossRef
- Daskalakis G, Anastasakis E, Papantoniou N, Mesogitis S, Theodora M, Antsaklis A (2007) Emergency obstetric hysterectomy. Acta Obstet Gynecol Scand 86(2):223–227 CrossRef
- Clark SL, Yeh SY, Phelan JP, Bruce S, Paul RH (1984) Emergency hysterectomy for obstetric hemorrhage. Obstet Gynecol 64(3):376–380
- Stanco LM, Schrimmer DB, Paul RH, Mishell DR Jr (1993) Emergency peripartum hysterectomy and associated risk factors. Am J Obstet Gynecol 168(3 Pt 1):879–883
- Baskett TF (2003) Emergency obstetric hysterectomy. J Obstet Gynaecol 23(4):353–355 CrossRef
- Kastner ES, Figueroa R, Garry D, Maulik D (2002) Emergency peripartum hysterectomy: experience at a community teaching hospital. Obstet Gynecol 99(6):971–975 CrossRef
- Zelop CM, Harlow BL, Frigoletto FD Jr, Safon LE, Saltzman DH (1993) Emergency peripartum hysterectomy. Am J Obstet Gynecol 168(5):1443–1448
- Oyelese Y, Smulian JC (2006) Placenta previa, placenta accreta, and vasa previa. Obstet Gynecol 107(4):927–941 Review CrossRef
- Yucel O, Ozdemir I, Yucel N, Somunkiran A (2006) Emergency peripartum hysterectomy: a 9-year review. Arch Gynecol Obstet 274(2):84–87 CrossRef
- Emergency peripartum hysterectomy
Archives of Gynecology and Obstetrics
Volume 283, Issue 4 , pp 723-727
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Emergency peripartum hysterectomy
- Postpartum hemorrhage
- Cesarean section
- Placenta previa accreta
- Industry Sectors