Incidence of postpartum post-cesarean hysterectomy at the Institute of Gynecology and Obsterics, Clinical Center of Serbia, Belgrade

Abstract

INTRODUCTION: Postpartum hysterectomy means hysterectomy at least 6 weeks after delivery or cesarean section. It is usually performed in life-threatening situations. Incidence of postpartum hysterectomy varies from 0.02% to 0.3% of total number of deliveries. OBJECTIVE: The aim of this study was to show and compare the incidence of postpartum hysterectomy after the cesarean section at the Institute of Gynecology and Obstetrics, Clinical Center of Serbia. We compared two five-year periods: the first period 1987-1982 and the second 2000-2004. METHOD: The retrospective study analyzed all patients treated at the Institute of Gynecology and Obstetrics who had had hysterectomy until six weeks after vaginal delivery or cesarean section. We analyzed the number of deliveries and the number of postpartum hysterectomies. RESULTS: There were 50,467 deliveries (3542 cesarean sections) and 91 postpartum hysterectomies (70 or 76.92% after cesarean section) in the first period. In the second period, there were 34,035 deliveries (7105 cesarean sections) and 64 hysterectomies (39 or 60.94 % after cesarean section). The overall incidence of postpartum hysterectomy was 1.98/1000 in the first and 1.88/1000 deliveries in the second period. The incidence of post-cesarean hysterectomy decreased from 19.76/1000 in the first period to 5.49/1000 in the second period. CONCLUSION: It is crucial for each obstetrician to cautiously distinguish and reach an appropriate decision about the exact indications for cesarean delivery having in mind growing incidence of cesarean sections, which is the main risk factor for puerperal morbidity and mortality.