Emergency peripartum hysterectomy and risk factors by mode of delivery and obstetric history: a 10-year review from Helsinki University Central Hospital
Abstract
Objective: This study aims to estimate the occurrence of emergency peripartum hysterectomy (EPH) and to quantify its risk factors in connection with the mode of delivery and the obstetric history of patients at the Helsinki University Central Hospital, Finland.
Methods: In a retrospective, matched case-control study we identified 124 cases of EPH from 2000 to 2010 at our hospital. These were matched with 248 control patients.
Results: The incidence rate of EPH was 9.9/10,000. Patients whose current delivery was vaginal, and had a cesarean section (CS) in their history had a six-fold risk for EPH. Women who underwent their first CS had a nine times higher risk, while patients who currently underwent CS and had a history of previous CS, had a 22 times higher risk. Those who experienced prostaglandin-E1 induction had a five-fold risk. Maternal age >35 years, previous curettage, and twin pregnancy were identified as significant risk factors. In 41 cases, interventions to reduce bleeding were performed.
Conclusion: Obstetric emergency training and guidelines for massive hemorrhage should be established in any delivery department. Moreover, all possible precautions should be taken to avoid the first CS if it is obstetrically unnecessary. Induction with prostaglandin-E1, maternal age >35 years, previous curettage, twin pregnancies, and early gestation were identified as risk factors for EPH.
References
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The authors stated that there are no conflicts of interest regarding the publication of this article.
©2015 by De Gruyter
Articles in the same Issue
- Frontmatter
- Editorial
- Maternal risk: assessment and management
- Original articles – Obstetrics
- Ebola virus screening during pregnancy in West Africa: unintended consequences
- Strain at the internal cervical os assessed with quasi-static elastography is associated with the risk of spontaneous preterm delivery at ≤34 weeks of gestation
- Can routine laboratory parameters predict adverse pregnancy outcomes in intrahepatic cholestasis of pregnancy?
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- Incidence and outcomes of women with Hodgkin’s lymphoma in pregnancy: a population-based study on 7.9 million births
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- Association of maternal blood pressure in pregnancy with blood pressure of their offspring through adolescence
- Oxytocin utilization for labor induction in obese and lean women
- Breech delivery in the all fours position: a prospective observational comparative study with classic assistance
- Position at birth as an important factor for the occurrence of anal sphincter tears: a retrospective cohort study
- Emergency peripartum hysterectomy and risk factors by mode of delivery and obstetric history: a 10-year review from Helsinki University Central Hospital
- Delivery outcomes after day and night onset of labour
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- Perinatal outcome of congenital heart disease in a population with high consanguinity
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- First-trimester fetal growth discordance and development of preeclampsia in dichorionic twin pregnancies
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- A longitudinal study of brainstem auditory response from birth to late term in late preterm babies and abnormal findings in high-risk babies
- Suctioning habits in the delivery room and the influence on postnatal adaptation – a video analysis
- Short communications
- Management of vasa previa during pregnancy
- Uterine rupture after the uterine fundal pressure maneuver
- Congress Calendar
- Congress Calendar
Articles in the same Issue
- Frontmatter
- Editorial
- Maternal risk: assessment and management
- Original articles – Obstetrics
- Ebola virus screening during pregnancy in West Africa: unintended consequences
- Strain at the internal cervical os assessed with quasi-static elastography is associated with the risk of spontaneous preterm delivery at ≤34 weeks of gestation
- Can routine laboratory parameters predict adverse pregnancy outcomes in intrahepatic cholestasis of pregnancy?
- Pulmonary edema in pregnancy and the puerperium: a cohort study of 53 cases
- Incidence and outcomes of women with Hodgkin’s lymphoma in pregnancy: a population-based study on 7.9 million births
- Differential utilization of expanded genetic screening tests in patients of reproductive ages from private and academic practices
- Association of maternal blood pressure in pregnancy with blood pressure of their offspring through adolescence
- Oxytocin utilization for labor induction in obese and lean women
- Breech delivery in the all fours position: a prospective observational comparative study with classic assistance
- Position at birth as an important factor for the occurrence of anal sphincter tears: a retrospective cohort study
- Emergency peripartum hysterectomy and risk factors by mode of delivery and obstetric history: a 10-year review from Helsinki University Central Hospital
- Delivery outcomes after day and night onset of labour
- Original articles – Fetus
- Perinatal outcome of congenital heart disease in a population with high consanguinity
- Complex and irregular heart rate dynamics in fetuses compromised by maternal anemia as a high-risk pregnancy
- Clinical application of fetal left modified myocardial performance index in the evaluation of fetal growth restriction
- First-trimester fetal growth discordance and development of preeclampsia in dichorionic twin pregnancies
- Original articles – Newborn
- Neonatal outcome in pregnant patients with antiphospholipid syndrome
- A longitudinal study of brainstem auditory response from birth to late term in late preterm babies and abnormal findings in high-risk babies
- Suctioning habits in the delivery room and the influence on postnatal adaptation – a video analysis
- Short communications
- Management of vasa previa during pregnancy
- Uterine rupture after the uterine fundal pressure maneuver
- Congress Calendar
- Congress Calendar