Peripartum hysterectomy in Taiwan.
OBJECTIVE
To investigate the incidence and associated risk factors for peripartum hysterectomy in singleton pregnancies.


METHODS
A retrospective cohort study of all women with singleton pregnancies admitted for delivery in 2002 taken from the National Healthcare Insurance database. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for maternal and hospital characteristics using logistic regression.


RESULTS
There were 287 peripartum hysterectomies in 214 237 singleton pregnancies (0.13%). Cesarean delivery, vaginal birth after cesarean (VBAC), and repeat cesarean delivery had higher hysterectomy rates than vaginal delivery, with adjusted ORs of 12.13 (95% CI 8.30-17.74), 5.12 (95% CI 1.19-21.92), and 3.84 (95% CI 2.52-5.86), respectively. Pregnancies complicated with placenta previa, gestational diabetes mellitus (GDM), and premature labor were associated with significantly increased risks for peripartum hysterectomy (P<0.05).


CONCLUSIONS
Risk factors for peripartum hysterectomy included cesarean delivery, VBAC, repeat cesarean, placenta previa, GDM, and premature labor. VBAC and repeat cesarean had a similar risk.
Jou
Hei-Jen
HJ
Department of Obstetrics and Gynecology, Taiwan Adventist Hospital, Taipei, Taiwan.
Hung
Hsin-Wen
HW
Ling
Pei-Ying
PY
Chen
Shih-Ming
SM
Wu
Shiao-Chi
SC
D000293:Adolescent; D000328:Adult; D002585:Cesarean Section; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D015994:Incidence; D007744:Obstetric Labor Complications; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000601:surgery; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology