title: Early postpartum hysterectomy: incidence and risk factors.
abstract: OBJECTIVE
  To determine the incidence and risk factors of early postpartum hysterectomy at the University Hospital in Vienna.
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  General Hospital Vienna, a tertiary referral center.
  
  
  METHODS
  All 15,858 women who gave birth between 1st January 2003 and 31st December 2008.
  
  
  METHODS
  Analysis of all cases of early postpartum hysterectomy using data from the clinical documentation system.
  
  
  METHODS
  Postpartum hysterectomy done during or within 24 hours of birth.
  
  
  RESULTS
  The incidence of early postpartum hysterectomy was 1.39/1,000. Abnormally adherent placenta was the most common cause for hysterectomy followed by uterine atony and uterine rupture. There were no maternal deaths. Abnormal placentation, increased blood loss and lower gestational age were significant risk factors in women undergoing hysterectomy. The newborns of these women had a lower birthweight, significantly lower Apgar scores at 1 and 5 minutes and were more often transferred to the neonatal intensive care unit (NICU). An additional analysis in a sample of women with uterine atony identified age as risk factor for hysterectomy.
  
  
  CONCLUSIONS
  Abnormal placentation, increased blood loss, low gestational age and maternal age are risk factors for early postpartum hysterectomy.
authors.affiliation: Department of Obstetrics and Gynaecology, Division of Feto-maternal Medicine and Obstetrics, Medical University Vienna, Vienna, Austria.
authors.forename: Maria
authors.initials: M
authors.lastname: Roethlisberger
authors.forename: Irene
authors.initials: I
authors.lastname: Womastek
authors.forename: Martin
authors.initials: M
authors.lastname: Posch
authors.forename: Peter
authors.initials: P
authors.lastname: Husslein
authors.forename: Norbert
authors.initials: N
authors.lastname: Pateisky
authors.forename: Rainer
authors.initials: R
authors.lastname: Lehner
mesh_terms: D000328:Adult; D000367:Age Factors; D001034:Apgar Score; D001724:Birth Weight; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D015994:Incidence; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D010921:Placenta Accreta / Q000601:surgery; D010923:Placenta Previa / Q000601:surgery; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000601:surgery; D049590:Postpartum Period; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D014593:Uterine Inertia / Q000601:surgery; D014597:Uterine Rupture / Q000601:surgery