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Risk of peripartum hysterectomy by mode of delivery and prior obstetric history: data from a population-based study

  • Materno-fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To provide an estimate of the incidence of peripartum hysterectomy in the state of New Jersey and calculate the effect of mode of delivery and prior obstetric history.

Methods

A perinatal-linked dataset provided by the Maternal Child Health Epidemiology Program in the New Jersey Department of Health was used to obtain information from birth certificates and hospital discharge records. Using multivariate logistic regression, various demographic and clinical factors were assessed for association with peripartum hysterectomy.

Results

A total of 1,004,116 births were identified between 1997 and 2005 and 853 peripartum hysterectomies were performed (0.85/1,000 deliveries). Parity increased the risk of hysterectomy with nulliparous women having approximately half the risk compared to multiparous women. Cesarean delivery with no previous c-section almost doubled the risk (OR 2.20, CI 1.80–26.69) while in the presence of a previous c-section the risk was almost four times higher (OR 4.51, CI 3.76–5.40). Operative vaginal delivery did not result in any increase in the risk.

Conclusions

Mode of delivery and prior obstetric history are major risk factors for peripartum hysterectomy. Patients desiring cesarean delivery need to be counseled on the risk of this serious complication.

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Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Temple University Hospital, Philadelphia, PA, USA

    Michail Spiliopoulos, Aparna Kareti & Vani Dandolu

  2. UMDNJ-School of Public Health, Piscataway, NJ, USA

    Neetu J. Jain

  3. Division of Family Health Services, New Jersey Department of Health and Senior Services, Trenton, NJ, USA

    Neetu J. Jain & Lakota K. Kruse

  4. Department of Biostatistics, Temple University Hospital, Philadelphia, PA, USA

    Alex Hanlon

  5. Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University Hospital, 7th Floor Outpatient Bldg., 3401 N. Broad Str, Philadelphia, PA, 19140, USA

    Michail Spiliopoulos

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  1. Michail Spiliopoulos
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  2. Aparna Kareti
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Correspondence to Michail Spiliopoulos.

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Spiliopoulos, M., Kareti, A., Jain, N.J. et al. Risk of peripartum hysterectomy by mode of delivery and prior obstetric history: data from a population-based study. Arch Gynecol Obstet 283, 1261–1268 (2011). https://doi.org/10.1007/s00404-010-1554-6

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  • DOI: https://doi.org/10.1007/s00404-010-1554-6

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