Peripartum hysterectomy in Denmark 1995-2004.
BACKGROUND
Severe postpartum hemorrhage (PPH) is a potentially life-threatening situation that sometimes requires a hysterectomy. We examined the national incidence, risk factors, indications, outcomes and complications of peripartum hysterectomy following vaginal and caesarean delivery.


METHODS
Peripartum hysterectomy was defined as a hysterectomy after birth until 1 month after delivery using the codes for hysterectomy from the NOMESCO classification (1995). National data from the period 1995-2004 were extracted from the Danish Medical Birth Register and linked to the Danish National Hospital Register followed by registration of relevant data from the medical records of all the patients.


RESULTS
We found 152 hysterectomies corresponding to an incidence of 0.24/1,000 deliveries. The risk of peripartum hysterectomy increased 11-fold following caesarean compared to vaginal delivery. Placenta accrete was present in 37% of the cases and 68%.


CONCLUSIONS
Peripartum hysterectomy has increased significantly during the last 20 years. Optimizing treatment of PPH may decrease the incidence of peripartum hysterectomy in the future.
Sakse
Abelone
A
Department of Obstetrics and Gynecology, University of Copenhagen, Hvidovre Hospital, Denmark. abelone.sakse@hvh.regionh.dk
Weber
Tom
T
Nickelsen
Carsten
C
Secher
Niels Jørgen
NJ
D003718:Denmark; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data* / Q000639:trends; D015994:Incidence; D006473:Postpartum Hemorrhage / Q000601:surgery*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors