Emergency peripartum hysterectomy: single center ten-year experience

Abstract

Purpose: The purpose of our study is to determine the incidence, risk factors, indications, outcomes, and complications of emergency peripartum hysterectomy (EPH) performed in a university hospital.

Methods: This retrospective study includes 54 cases of EPH performed at the department of obstetrics and gynecology of Gaziantep University Hospital between the years 2005–2015. We included all hysterectomy cases during the first 24 h after delivery beyond 20 weeks of gestation. We compared the most common indications of EPH between each other.

Results: There were 54 EPH out of 8922 deliveries with an incidence of 6.1 per 1000 deliveries during the study period. The most common indication was abnormal placentation (74.0%). Urinary tract injury (33.4%) was the most common intraoperative complication. Bilateral hypogastric artery ligation, urinary tract injury, type of hysterectomy, post-op stay in the hospital, delivery in another hospital and other complications were significantly related to the type of EPH indication (p < 0.05).

Conclusion: Abnormal placentation was the most common indication for EPH. Previous CS can be suggested as a high-risk factor for abnormal placentation. The delivery should be performed in appropriate clinical settings with experienced surgeons when high-risk factors like abnormal placentations are determined preoperatively.

Keywords:

• Emergency peripartum hysterectomy
• abnormal placentation
• uterine atony
• uterine rupture

Acknowledgements

The first author would like to thank Assoc. Prof. Dr. Seval Kul for her assistance in the statistical analysis of the manuscript.

Disclosure statement

The authors report that they have no conflicts of interest.