Peripartum cesarean hysterectomy: critical analysis of risk factors and trends over the years

The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
Adi OrbachEyal Sheiner

Abstract

To investigate time trends and risk factors for peripartum cesarean hysterectomy. A population-based study comparing all deliveries that were complicated with peripartum hysterectomy to deliveries without this complication was conducted. Deliveries occurred during the years 1988-2007 at a tertiary medical center. A multiple logistic regression model was constructed to find independent risk factors associated with peripartum hysterectomy. Emergency peripartum cesarean hysterectomy complicated 0.06% (n=125) of all deliveries in the study period (n=211,815). The incidence of peripartum hysterectomy increased over time (1988-1994, 0.04%; 1995-2000, 0.05%; 2001-2007, 0.095%). Independent risk factors for emergency peripartum hysterectomy from a backward, stepwise, multivariable logistic regression model were: uterine rupture (OR=487; 95% CI 257.8-919.8, p<0.001), placenta previa (OR=66.4; 95% CI 39.8-111, p<0.001), postpartum hemorrhage (PPH) (OR=40.8; 95% CI 22.4-74.6, p<0.001), cervical tears (OR=22.3; 95% CI 10.4-48.1, p<0.001), second trimester bleeding (OR=6; 95% CI 1.8-20, p=0.003), previous cesarean delivery (OR=5.4; 95% CI 3.5-8.4, p<0.001), placenta accreta (OR=4.7; 95% CI 1.9-11.7, p=0.001), and grand multiparity (above fi...Continue Reading

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Citations

Sep 20, 2012·Archives of Gynecology and Obstetrics·Fabio ParazziniGiuseppe Bulfoni
Nov 12, 2013·Archives of Gynecology and Obstetrics·Sadik SahinMustafa Serdar Yaşartekin
Mar 8, 2012·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Roy KessousEyal Sheiner
Jan 30, 2013·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Ron Charach, Eyal Sheiner
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