Indications for and outcomes of emergency peripartum hysterectomy. A five-year review.
OBJECTIVE
To review risk factors, management and outcomes of emergency peripartum hysterectomy performed in the last five years at Stony Brook University Hospital.


METHODS
Retrospective descriptive and cohort analyses from January 1990 to January 1995. Incidences of emergency peripartum hysterectomy and placenta accreta were determined. Relative risks of hysterectomy for specified risk factors were calculated.


RESULTS
There were 39 cases of emergency peripartum hysterectomy, for an overall incidence of 2.7/1,000 births. Indications for emergency hysterectomy were placenta accreta, unspecified bleeding, uterine rupture, myomas and atony with placenta accreta, the most common. The crude relative risk of emergency hysterectomy was 46.9 (n = 37) for cesarean delivery, 15.24 (n = 31) for prior cesarean delivery and 110.83 (n = 21) for placenta previa.


CONCLUSIONS
Cesarean delivery, prior cesarean delivery, placenta accreta and uterine atony were identified as risk factors for emergency peripartum hysterectomy, and abnormal placentation was the primary cause of cesarean hysterectomy.
Bakshi
S
S
Department of Obstetrics and Gynecology, University Medical Center, State University of New York at Stony Brook 11794-8091, USA.
Meyer
B A
BA
D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D004638:Emergency Treatment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D008875:Middle Aged; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors