Skip to main content
Top
Published in: Archives of Gynecology and Obstetrics 5/2014

01-05-2014 | Maternal-Fetal Medicine

Emergency peripartum hysterectomy: our 12-year experience

Authors: Sadik Sahin, Kadir Guzin, Mustafa Eroğlu, Furkan Kayabasoglu, Mustafa Serdar Yaşartekin

Published in: Archives of Gynecology and Obstetrics | Issue 5/2014

Login to get access

Abstract

Objective

The aim of this study was to determine the incidence, indications and the risk factors and complications of emergency peripartum hysterectomy (EPH).

Methods

We analyzed retrospectively 44 cases of EPH performed at tertiary obstetric center between January 2001 and April 2013. Data related to demographics, reproductive histories, indications for EPH, and postoperative follow-up were obtained by analyses of hospital records.

Results

The overall incidence of EPH was 0.48 per 1,000 deliveries during the study period. The most common indications of EPH were abnormal placentation (50 %), uterine atony (36 %) and uterine rupture (9 %). All patients who underwent EPH with abnormal placentation had one or more previous cesarean sections (CS) except one. In our series, 24 cases (54 %) underwent total hysterectomy, most of which had the diagnosis of abnormal placentation (75 %), whereas subtotal hysterectomy was the choice of management of bleeding in cases with uterine atony (60 %). Maternal mortality was seen in 2 patients (4.5 %). The causes were disseminated intravascular coagulation in one and adult respiratory distress syndrome in the other patient. Perinatal mortality was observed in 7 patients (16 %). The causes for perinatal mortality were placental abruption in 4 and prematurity in 3 patients.

Conclusions

In our series, abnormal placentation was the most common indication for EPH. The risk factors for EPH were previous CS for abnormal placentation and placental abruption for uterine atony and peripartum hemorrhage. Limiting the number of CS deliveries would bring a significant impact on decreasing the risk of EPH.
Literature
1.
go back to reference Bateman BT, Mhyre JM, Callaghan WM, Kuklina EV (2012) Peripartum hysterectomy in the United States: nationwide 14 year experience. Am J Obstet Gynecol 206(1):63.e1–63.e8 Bateman BT, Mhyre JM, Callaghan WM, Kuklina EV (2012) Peripartum hysterectomy in the United States: nationwide 14 year experience. Am J Obstet Gynecol 206(1):63.e1–63.e8
2.
go back to reference Wright JD, Bonanno C, Shah M, Gaddipati S, Devine P (2010) Peripartum hysterectomy. Obstet Gynecol 116(2):429–434PubMedCrossRef Wright JD, Bonanno C, Shah M, Gaddipati S, Devine P (2010) Peripartum hysterectomy. Obstet Gynecol 116(2):429–434PubMedCrossRef
3.
go back to reference Flood KM, Said S, Geary M, Robson M, Fitzpatrick C, Malone FD (2009) Changing trends in peripartum hysterectomy over the last 4 decades. Am J Obstet Gynecol 200((6):632.e1–632.e6 Flood KM, Said S, Geary M, Robson M, Fitzpatrick C, Malone FD (2009) Changing trends in peripartum hysterectomy over the last 4 decades. Am J Obstet Gynecol 200((6):632.e1–632.e6
4.
go back to reference 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(3):251–256PubMedCrossRef 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(3):251–256PubMedCrossRef
5.
go back to reference Taylor FB Jr, Toh CH, Hoots WK, Wada H, Levi M (2001) Towards definition, clinical and laboratory criteria and a scoring system for disseminated intravascular coagulation. J Thromb Haemost 86(5):1327–1330 Taylor FB Jr, Toh CH, Hoots WK, Wada H, Levi M (2001) Towards definition, clinical and laboratory criteria and a scoring system for disseminated intravascular coagulation. J Thromb Haemost 86(5):1327–1330
6.
go back to reference Hawkins J, Hudson CN (1977) Abdominal hysterectomy for benign conditions. In: Hawkins J, Hudson CN (eds) Shaw’s textbook of operative gynaecology, 4th edn. Churchill Livingstone, Scotland, pp 146–175 Hawkins J, Hudson CN (1977) Abdominal hysterectomy for benign conditions. In: Hawkins J, Hudson CN (eds) Shaw’s textbook of operative gynaecology, 4th edn. Churchill Livingstone, Scotland, pp 146–175
7.
go back to reference Sakse A, Weber T, Nickelsen C, Secher NJ (2007) Peripartum hysterectomy in Denmark 1995–2004. Acta Obstet Gynecol Scand 86(12):1472–1475PubMedCrossRef Sakse A, Weber T, Nickelsen C, Secher NJ (2007) Peripartum hysterectomy in Denmark 1995–2004. Acta Obstet Gynecol Scand 86(12):1472–1475PubMedCrossRef
8.
go back to reference Kwee A, Bots ML, Visser GHA, Bruinse HW (2006) Emergency peripartum hysterectomy: a prospective study in the Netherlands. Eur J Obstet Gynecol 124(12):187–192CrossRef Kwee A, Bots ML, Visser GHA, Bruinse HW (2006) Emergency peripartum hysterectomy: a prospective study in the Netherlands. Eur J Obstet Gynecol 124(12):187–192CrossRef
9.
go back to reference Wen SW, Huang L, Liston R, Heaman M, Baskett T, Rusen ID, Joseph KS, Kramer MS (2005) Severe maternal morbidity in Canada 1991–2001. CMAJ 173(7):759–764PubMedCentralPubMedCrossRef Wen SW, Huang L, Liston R, Heaman M, Baskett T, Rusen ID, Joseph KS, Kramer MS (2005) Severe maternal morbidity in Canada 1991–2001. CMAJ 173(7):759–764PubMedCentralPubMedCrossRef
10.
go back to reference Owolabi MS, Blake RE, Mayor MT, Adegbulugbe HA (2013) Incidence and determinants of peripartum hysterectomy in the metropolitan area of the District of Columbia. J Reprod Med 58(3–4):167–172PubMed Owolabi MS, Blake RE, Mayor MT, Adegbulugbe HA (2013) Incidence and determinants of peripartum hysterectomy in the metropolitan area of the District of Columbia. J Reprod Med 58(3–4):167–172PubMed
11.
go back to reference Omole-Ohonsi A, Olayinka HT (2012) Emergency peripartum hysterectomy in a developing country. J Obstet Gynaecol Can 34(10):954–960PubMed Omole-Ohonsi A, Olayinka HT (2012) Emergency peripartum hysterectomy in a developing country. J Obstet Gynaecol Can 34(10):954–960PubMed
12.
go back to reference Mahrukh F, Pashtoon MK, Shahnaz NB, Abaseen K (2011) Afghan experience of emergency peripartum hysterectomies at a tertiary care hospital in Quetta, Pakistan. ISRN Obstet Gynecol, article Id 854202 Mahrukh F, Pashtoon MK, Shahnaz NB, Abaseen K (2011) Afghan experience of emergency peripartum hysterectomies at a tertiary care hospital in Quetta, Pakistan. ISRN Obstet Gynecol, article Id 854202
13.
go back to reference Babinszki A, Kerenyi T, Torok O, Grazi V, Lapinski RH, Berkowitz RL (1999) Perinatal outcome in grand and great-grand multiparity: effects of parity on obstetric risk factors. Am J Obstet Gynecol 181(3):669–674PubMedCrossRef Babinszki A, Kerenyi T, Torok O, Grazi V, Lapinski RH, Berkowitz RL (1999) Perinatal outcome in grand and great-grand multiparity: effects of parity on obstetric risk factors. Am J Obstet Gynecol 181(3):669–674PubMedCrossRef
14.
go back to reference Chen M, Zhang L, Wei Q, Fu X, Gao Q, Liu X (2013) Peripartum hysterectomy between 2009 and 2010 in Sichuan, China. Int J Gynaecol Obstet 120(2):183–186PubMedCrossRef Chen M, Zhang L, Wei Q, Fu X, Gao Q, Liu X (2013) Peripartum hysterectomy between 2009 and 2010 in Sichuan, China. Int J Gynaecol Obstet 120(2):183–186PubMedCrossRef
15.
go back to reference Bakshi S, Meyer BA (2000) Indications for and outcomes of emergency peripartum hysterectomy. A five-year review. J Reprod Med 45(9):733–737PubMed Bakshi S, Meyer BA (2000) Indications for and outcomes of emergency peripartum hysterectomy. A five-year review. J Reprod Med 45(9):733–737PubMed
16.
go back to reference Yucel O, Ozdemir I, Yucel N, Somunkiran A (2006) Emergency peripartum hysterectomy: a 9-year review. Arch Gynecol Obstet 274(2):84–87PubMedCrossRef Yucel O, Ozdemir I, Yucel N, Somunkiran A (2006) Emergency peripartum hysterectomy: a 9-year review. Arch Gynecol Obstet 274(2):84–87PubMedCrossRef
17.
go back to reference Rossi AC, Lee RH, Chmait RH (2010) Emergency postpartum hysterectomy for uncontrolled postpartum bleeding: a systematic review. Obstet Gynecol 115(3):637–644PubMedCrossRef Rossi AC, Lee RH, Chmait RH (2010) Emergency postpartum hysterectomy for uncontrolled postpartum bleeding: a systematic review. Obstet Gynecol 115(3):637–644PubMedCrossRef
18.
go back to reference Jou HJ, Hung HW, Ling PY, Chen SM, Wu SC (2008) Peripartum hysterectomy in Taiwan. Int J Gynecol Obstet 101(3):269–272CrossRef Jou HJ, Hung HW, Ling PY, Chen SM, Wu SC (2008) Peripartum hysterectomy in Taiwan. Int J Gynecol Obstet 101(3):269–272CrossRef
19.
go back to reference Rahman J, Al-Ali M, Qutub HO, Al-Suleiman SS, Al-Jama FE, Rahman MS (2008) Emergency obstetric hysterectomy in a university hospital: a 25-year review. J Obstet Gynaecol 28(1):69–72PubMedCrossRef Rahman J, Al-Ali M, Qutub HO, Al-Suleiman SS, Al-Jama FE, Rahman MS (2008) Emergency obstetric hysterectomy in a university hospital: a 25-year review. J Obstet Gynaecol 28(1):69–72PubMedCrossRef
20.
go back to reference Zelop CM, Harlow BL, Frigoletto FD Jr, Safon LE, Saltzman DH (1993) Emergency peripartum hysterectomy. Am J Obstet Gynecol 168(5):1443–1448PubMedCrossRef Zelop CM, Harlow BL, Frigoletto FD Jr, Safon LE, Saltzman DH (1993) Emergency peripartum hysterectomy. Am J Obstet Gynecol 168(5):1443–1448PubMedCrossRef
21.
go back to reference Selo-Ojeme DO, Bhattacharjee P, Izuwa-Njoku NF, Kadir RA (2005) Emergency peripartum hysterectomy in a tertiary London hospital. Arch Gynecol Obstet 271(2):154–159PubMedCrossRef Selo-Ojeme DO, Bhattacharjee P, Izuwa-Njoku NF, Kadir RA (2005) Emergency peripartum hysterectomy in a tertiary London hospital. Arch Gynecol Obstet 271(2):154–159PubMedCrossRef
22.
go back to reference Hershkowitz R, Fraser D, Mazor M, Leiberman JR (1995) One or multiple previous cesarean sections are associated with similar increased frequency of placenta previa. Eur J Obstet Gynecol Reprod Biol 62(2):185–188PubMedCrossRef Hershkowitz R, Fraser D, Mazor M, Leiberman JR (1995) One or multiple previous cesarean sections are associated with similar increased frequency of placenta previa. Eur J Obstet Gynecol Reprod Biol 62(2):185–188PubMedCrossRef
23.
go back to reference Miller DA, Chollet JA, Goodwin TM (1997) Clinical risk factors for placenta previa-placenta accreta. Am J Obstet Gynecol 177(1):210–214PubMedCrossRef Miller DA, Chollet JA, Goodwin TM (1997) Clinical risk factors for placenta previa-placenta accreta. Am J Obstet Gynecol 177(1):210–214PubMedCrossRef
24.
go back to reference Forna F, Miles AM, Jamieson DJ (2004) Emergency peripartum hysterectomy: a comparison of cesarean and postpartum hysterectomy. Am J Obstet Gynecol 190(5):1440–1444PubMedCrossRef Forna F, Miles AM, Jamieson DJ (2004) Emergency peripartum hysterectomy: a comparison of cesarean and postpartum hysterectomy. Am J Obstet Gynecol 190(5):1440–1444PubMedCrossRef
25.
go back to reference Knight M, Kurinczuk JJ, Spark P, Brocklehurst P (2008) Cesarean delivery and peripartum hysterectomy. Obstet Gynecol 111(1):97–105PubMedCrossRef Knight M, Kurinczuk JJ, Spark P, Brocklehurst P (2008) Cesarean delivery and peripartum hysterectomy. Obstet Gynecol 111(1):97–105PubMedCrossRef
26.
go back to reference Orbach A, Levy A, Wiznitzer A, Mazor M, Holcberg G, Sheiner E (2011) Peripartum cesarean hysterectomy: critical analysis of risk factors and trends over the years. J Matern Fetal Neonatal Med 24(3):480–484PubMedCrossRef Orbach A, Levy A, Wiznitzer A, Mazor M, Holcberg G, Sheiner E (2011) Peripartum cesarean hysterectomy: critical analysis of risk factors and trends over the years. J Matern Fetal Neonatal Med 24(3):480–484PubMedCrossRef
27.
go back to reference Sumigama S, Itakura A, Ota T et al (2007) Placenta previa increta/percreta in Japan: a retrospective study of ultrasound findings, management and clinical course. J Obstet Gynaecol Res 33(5):606–611PubMedCrossRef Sumigama S, Itakura A, Ota T et al (2007) Placenta previa increta/percreta in Japan: a retrospective study of ultrasound findings, management and clinical course. J Obstet Gynaecol Res 33(5):606–611PubMedCrossRef
29.
go back to reference Güngördük K, Yildirim G, Dugan N, Polat I, Sudolmus S, Ark C (2009) Peripartum hysterectomy in Turkey: a case–control study. J Obstet Gynaecol 29(8):722–728PubMedCrossRef Güngördük K, Yildirim G, Dugan N, Polat I, Sudolmus S, Ark C (2009) Peripartum hysterectomy in Turkey: a case–control study. J Obstet Gynaecol 29(8):722–728PubMedCrossRef
30.
go back to reference Whiteman MK, Kuklina E, Hillis SD, Jamieson DJ, Meikle SF, Posner SF, Marchbanks PA (2006) Incidence and determinants of peripartum hysterectomy. Obstet Gynecol 108(6):1486–1492PubMedCrossRef Whiteman MK, Kuklina E, Hillis SD, Jamieson DJ, Meikle SF, Posner SF, Marchbanks PA (2006) Incidence and determinants of peripartum hysterectomy. Obstet Gynecol 108(6):1486–1492PubMedCrossRef
31.
go back to reference Parazzini F, Ricci E, Cipriani S, Chiaffarino F, Bortolus R, Chiantera V, Bulfoni G (2013) Temporal trends and determinants of peripartum hysterectomy in Lombardy, Northern Italy, 1996–2010. Arch Gynecol Obstet 287(2):223–228PubMedCrossRef Parazzini F, Ricci E, Cipriani S, Chiaffarino F, Bortolus R, Chiantera V, Bulfoni G (2013) Temporal trends and determinants of peripartum hysterectomy in Lombardy, Northern Italy, 1996–2010. Arch Gynecol Obstet 287(2):223–228PubMedCrossRef
32.
go back to reference Kastner ES, Figueroa R, Garry D, Maulik D (2002) Emergency peripartum hysterectomy: experience at a community teaching hospital. Obstet Gynecol 99(6):971–975PubMedCrossRef Kastner ES, Figueroa R, Garry D, Maulik D (2002) Emergency peripartum hysterectomy: experience at a community teaching hospital. Obstet Gynecol 99(6):971–975PubMedCrossRef
33.
go back to reference Glaze S, Ekwalanga P, Roberts G, Lange I, Birch C, Rosengarten A, Jarrell J, Ross S (2008) Peripartum hysterectomy 1999 to 2006. Obstet Gynecol 111(3):732–738PubMedCrossRef Glaze S, Ekwalanga P, Roberts G, Lange I, Birch C, Rosengarten A, Jarrell J, Ross S (2008) Peripartum hysterectomy 1999 to 2006. Obstet Gynecol 111(3):732–738PubMedCrossRef
34.
go back to reference Rahman J, Al-Ali M, Qutub HO, Al-Suleiman SS, Al-Jama FE, Rahman MS (2008) Emergency obstetric hysterectomy in a university hospital: a 25-year review. J Obstet Gynaecol 28(3):69–72PubMedCrossRef Rahman J, Al-Ali M, Qutub HO, Al-Suleiman SS, Al-Jama FE, Rahman MS (2008) Emergency obstetric hysterectomy in a university hospital: a 25-year review. J Obstet Gynaecol 28(3):69–72PubMedCrossRef
36.
go back to reference James AH, Jamison MG, Brancazio LR, Myers ER (2006) Venous thromboembolism during pregnancy and the postpartum period: incidence, risk factors, and mortality. Am J Obstet Gynecol 194(5):1311PubMedCrossRef James AH, Jamison MG, Brancazio LR, Myers ER (2006) Venous thromboembolism during pregnancy and the postpartum period: incidence, risk factors, and mortality. Am J Obstet Gynecol 194(5):1311PubMedCrossRef
37.
go back to reference Wright JD, Devine P, Shah M et al (2010) Morbidity and mortality of peripartum hysterectomy. Obstet Gynecol 115(6):1187–1193PubMedCrossRef Wright JD, Devine P, Shah M et al (2010) Morbidity and mortality of peripartum hysterectomy. Obstet Gynecol 115(6):1187–1193PubMedCrossRef
38.
go back to reference El-Jallad MF, Zayed F, Al-Rimawi HS (2004) Emergency peripartum hysterectomy in Northern Jordan: indications and obstetric outcome (an 8-year review). Arch Gynecol Obstet 270(4):271–273PubMedCrossRef El-Jallad MF, Zayed F, Al-Rimawi HS (2004) Emergency peripartum hysterectomy in Northern Jordan: indications and obstetric outcome (an 8-year review). Arch Gynecol Obstet 270(4):271–273PubMedCrossRef
Metadata
Title
Emergency peripartum hysterectomy: our 12-year experience
Authors
Sadik Sahin
Kadir Guzin
Mustafa Eroğlu
Furkan Kayabasoglu
Mustafa Serdar Yaşartekin
Publication date
01-05-2014
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 5/2014
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-013-3079-2

Other articles of this Issue 5/2014

Archives of Gynecology and Obstetrics 5/2014 Go to the issue