title: Peripartum hysterectomy in 38 hospitals in China: a population-based study.
abstract: OBJECTIVE
  To investigate the incidence, indications, risk factors and transfusions of peripartum hysterectomy in China.
  
  
  METHODS
  A population-based study was conducted using inpatient records of 38 hospitals between 1 January 2011 and 31 December 2011; multivariate logistic regression analysis was used to identify independent risk factors for peripartum hysterectomy.
  
  
  RESULTS
  During the study period, there were 43 peripartum hysterectomy cases out of 114,420 deliveries (0.38‰). Abnormal placentation was major indication for peripartum hysterectomy. Several factors significantly increased the risk of peripartum hysterectomy in this population: placenta previa/accreta [adjusted odds ratio (aOR) 49.7, 95 % CI 25.0-98.9], maternal age ≥35 years (aOR 8.1, 95% CI 4.0-16.0), preeclampsia/eclampsia (aOR 7.5, 95% CI 2.6-21.7), cesarean delivery (aOR 3, 95% CI 1.1-8.0), and multiparity (aOR 2.7, 95% CI 1.2-5.4). In contrast, multiple gestations did not.
  
  
  CONCLUSIONS
  Placenta previa/accreta, maternal age ≥35 years, preeclampsia/eclampsia, cesarean delivery and multiparity were risk factors of peripartum hysterectomy.
authors.affiliation: Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, No. 20, Section 3, Ren Min Nan Lu, Chengdu, 610041, Sichuan, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wei
authors.forename: Weiyuan
authors.initials: W
authors.lastname: Zhang
authors.forename: Meng
authors.initials: M
authors.lastname: Chen
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.forename: Guolin
authors.initials: G
authors.lastname: He
authors.forename: Xinghui
authors.initials: X
authors.lastname: Liu
mesh_terms: D000328:Adult; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000009:adverse effects; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D015994:Incidence; D008423:Maternal Age; D010298:Parity; D058725:Peripartum Period; D010922:Placenta Diseases / Q000601:surgery; D010923:Placenta Previa / Q000601:surgery; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors