Evaluation of parameters that influence morbidity in peripartum hysterectomy

Abstract

Objective: To evaluate which factors affect the intraoperative and postoperative morbidity in cases of peripartum hysterectomy. Study design: A retrospective study of all cases of peripartum hys te rectomy performed during a 5-year period (January 2008–June 2013) in a tertiary maternity hospital. Results: A total of 22,437 deliveries were reviewed and 63 cases of peripartum hysterectomy (2.8/1000) were identified. The indications for peripartum hysterectomy included: uterine atony (10 cases—15.9%), placenta accreta (21 cases—33.3%), placenta previa (30 cases—47.6%) and cervical pregnancy (2 cases—3.2%). Significantly higher rates of perioperative blood transfusion were noted in the emergency cases group, compared to the elective hysterectomies. Hypo gastric artery ligation did not have any significant impact on the outcome. Preoperative bilateral ureteral catheterization was associated with lower need for blood transfusion (p < 0.001), and with less complications, although this was not statistically significant. Conclusion: Maternal morbidity is significantly higher in emer gency cases of peripartum hysterectomies compared to expected-planned cases.