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Archives of Gynecology and Obstetrics

, Volume 290, Issue 5, pp 891–896 | Cite as

Incidence of emergency peripartum hysterectomy in Ain-shams University Maternity Hospital, Egypt: a retrospective study

  • Ihab Serag AllamEmail author
  • Ihab Adel Gomaa
  • Hisham Mohamed Fathi
  • Ghada Fathi Mahmoud Sukkar
Maternal-Fetal Medicine

Abstract

Purpose

To estimate the incidence of emergency peripartum hysterectomy over 6 years in Ain-shams University Maternity Hospital.

Methods

Detailed chart review of all cases of emergency peripartum hysterectomy, 2003–2008, including previous obstetric history, details of the index pregnancy, indications for emergency peripartum hysterectomy, outcome of the hysterectomy and infant morbidity.

Results

The overall rate of emergency peripartum hysterectomy was 149 of 66,306 or 2.24 per 1,000 deliveries. The primary indications for hysterectomies were placenta accreta/increta 59 (39.6 %), uterine atony 37 (24.8 %), uterine rupture 35 (23.5 %) and placenta previa without accreta 18 (12.1 %). After hysterectomy, 115 (77 %) women were admitted to the intensive care unit. Women were discharged home after a mean 11.2 day length of stay. Using multifactorial logistic regression analysis, we found that woman’s age, atonic uterus, placenta accreta/increta, previous cesarian section and ruptured uterus were independent predictors for peripartum hysterectomy

Conclusion

Abnormal placentation was the main indication for peripartum hysterectomy. The risk factors for peripartum hysterectomy were morbid adherence of placentae in scared uteri, uterine atony and uterine rupture. The most important step in prevention of major postpartum hemorrhage is recognizing and assessing women’s risk. The risk of peripartum hysterectomy seems to be significantly decreased by limiting the number of cesarean section deliveries, thus reducing the occurrence of abnormal placentation in the form of placenta accreta, increta or percreta.

Keywords

Abnormal placentation Maternal morbidity and mortality Peripartum hysterectomy Placenta accreta Placenta previa Uterine atony Cesarean hysterectomy 

Abbreviations

ANOVA

Analysis of variance

CI

Confidence interval

DIC

Disseminated intravascular coagulopathy

ICU

Intensive care unit

OR

Odds ratio

RR

Relative risk

Notes

Acknowledgments

The research was funded by the authors.

Conflict of interest

The authors reported no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Ihab Serag Allam
    • 1
    • 2
    Email author
  • Ihab Adel Gomaa
    • 1
  • Hisham Mohamed Fathi
    • 1
  • Ghada Fathi Mahmoud Sukkar
    • 1
  1. 1.Obstetrics and Gynaecology Department, Ain-shams Faculty of MedicineAin Shams University Maternity HospitalCairoEgypt
  2. 2.CairoEgypt

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