Risk factors for peripartum hysterectomy following uterine rupture.
OBJECTIVE
To investigate risk factors for hysterectomy following uterine rupture.


METHODS
A population-based study comparing all uterine ruptures with and without hysterectomy between 1988 and 2011 was conducted. Stratified analysis was performed using a multiple logistic regression analysis.


RESULTS
Peripartum hysterectomy complicated 20.7% (n = 34) of uterine ruptures during the study period (n = 164). Independent risk factors for hysterectomy following uterine rupture, from a multivariable logistic regression model, were relaparotomy (OR = 32.2, 95% CI = 2.5-421.9), extended tears involving the uterine cervix (OR = 6.1, 95% CI = 1.5-24.7), severe bleeding requiring packed cells transfusions (OR = 13.7, 95% CI = 3.2-58.5) and grand multiparity (≥5 deliveries, OR = 11.4 95% CI = 2.7-47.1).


CONCLUSIONS
Hysterectomy is not common following uterine rupture. Independent risk factors for hysterectomy include relaparotomy, extended tears involving the uterine cervix, severe bleeding requiring packed cells transfusions and grand multiparity. Trained obstetricians should be involved in cases of uterine rupture and the possibility for conducting hysterectomy should be emphasized.
Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Ron
R
Charach
Eyal
E
Sheiner
D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data / Q000639:trends*; D007557:Israel / Q000453:epidemiology; D058725:Peripartum Period; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D014597:Uterine Rupture / Q000453:epidemiology / Q000601:surgery*