Early postpartum hysterectomy: incidence and risk factors.
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.
Roethlisberger
Maria
M
Department of Obstetrics and Gynaecology, Division of Feto-maternal Medicine and Obstetrics, Medical University Vienna, Vienna, Austria.
Womastek
Irene
I
Posch
Martin
M
Husslein
Peter
P
Pateisky
Norbert
N
Lehner
Rainer
R
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