Abstract
Purpose
To determine the incidence, indications and the risk factors of emergency peripartum hysterectomy (EPH).
Methods
We analyzed retrospectively 30 cases of emergency peripartum hysterectomy performed at the Obstetrics Department of a tertiary, research and education hospital between the years of 2006 and 2010. Demographic, medical and clinical data of the patients were recorded. Data stored were expressed as mean ± standard deviation.
Results
There were 30 cases of EPH among 82,363 deliveries. The overall incidence of EPH was 0.364 per 1,000 deliveries from 2006 to 2010. Nine hysterectomies were performed after vaginal delivery (0.16/1,000 vaginal deliveries) and the remaining 21 hysterectomies were performed after cesarean section (0.78/1,000 cesarean sections). Two cases (6.7 %) were performed as subtotal and remaining 28 cases (93.3 %) were performed as total hysterectomy. Indications of EPH were uterine atony (43.3 %, 13/30), placenta accreta (40.0 %, 12/30) and uterine rupture (16.7 %, 5/30). All patients [7/7 (100 %)] with placenta previa and 11 of 12 patients (91.7 %) with placenta accreta had previously cesarean sections. There were two maternal deaths due to coagulopathy and pulmonary embolism. Two stillbirths (6.6 %) and 2 early neonatal deaths (6.6 %) were recorded.
Conclusions
It should be kept in mind that cases of placenta previa and/or placenta accreta with previous cesarean sections have a very high probability of EPH. The delivery should be performed in suitable clinical settings with experienced surgeons when the risk factors like placenta previa and/or placenta accreta are determined so as to achieve optimal outcome.
Similar content being viewed by others
References
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 120:57–62
Sturdee DW, Rushton DI (1983) Cesarean and post-partum hysterectomy. Br J Obstet Gynaecol 93:270–274
Kwee A, Bots ML, Visser GHA, Bruinse HW (2006) Emergency peripartum hysterectomy: a prospective study in the Netherlands. Eur J Obstet Gynecol Reprod Biol 124:187–192
Akar ME, Yilmaz ES, Yuksel B, Yilmaz Z (2004) Emergency peripartum hysterectomy. Eur J Obstet Gynecol Reprod Biol 113:178–181
Yucel O, Ozdemir I, Yucel N, Somunkiran A (2006) Emergency peripartum hysterectomy: a 9-year review. Arch Gynecol Obstet 274:84–87
Yalinkaya A, Guzel AI, Kangal K (2010) Emergency peripartum hysterectomy: 16-year experience of a medical hospital. J Chin Med Assoc 73:360–363
Kayabasoglu F, Guzin K, Aydogdu S, Sezginsoy S, Turkgeldi L, Gunduz G (2008) Emergency peripartum hysterectomy in a tertiary Istanbul hospital. Arch Gynecol Obstet 278:251–256
Engelsen IB, Albrechtsen S, Iversen OE (2001) Peripartum hysterectomy—incidence and maternal morbidity. Acta Obstet Gynecol Scand 80:409–412
Gardeil F, Daly S, Turner MJ (1995) Peripartum hysterectomy. Report of eleven cases. Rev Fr Gynecol Obstet 90:431–434
Bakshi S, Meyer BA (2000) Indication for and outcomes of emergency peripartum hysterectomy. A five-year review. J Reprod Med 45:733–737
Machado LSM (2011) Emergency peripartum hysterectomy: incidence, indications, risk factors and outcome. N Am J Med Sci 3:358–361
Yamani Zamzami TY (2003) Indications of emergency peripartum hysterectomy: review of 17 cases. Arch Gynecol Obstet 268:131–135
Selo-Ojeme DO, Bhattacharjee P, Izuwa-Njoku NF, Kadir RA (2005) Emergency peripartum hysterectomy in a tertiary London hospital. Arch Gynecol Obstet 271:154–159
Turner MJ (2010) Peripartum hysterectomy: an evolving picture. Int J Gynecol Obstet 109:9–11
Lone F, Sultan AH, Thakar R, Beggs A (2010) Risk factors and management patterns for emergency obstetric hysterectomy over 2 decades. Int J Gynecol Obstet 109:12–15
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tapisiz, O.L., Altinbas, S.K., Yirci, B. et al. Emergency peripartum hysterectomy in a tertiary hospital in Ankara, Turkey: a 5-year review. Arch Gynecol Obstet 286, 1131–1134 (2012). https://doi.org/10.1007/s00404-012-2434-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-012-2434-z