title: Maternal and perinatal outcomes following peripartum hysterectomy from a single tertiary centre.
abstract: BACKGROUND
  We investigated the indications for and maternal and perinatal outcomes following peripartum hysterectomy in a single large tertiary centre.
  
  
  METHODS
  All cases of peripartum hysterectomy between 2000 and 2011 were investigated. Data regarding maternal demographics, previous obstetric and gynaecological history, indications for hysterectomy, and details of haemorrhage, surgical complications and neonatal outcomes were collected.
  
  
  RESULTS
  There were 47 cases of peripartum hysterectomy of 55 262 births giving an incidence of 0.85 per 1000 births. Forty-one cases were total hysterectomies, while six were subtotal procedures. A total of 70.2% of cases were performed because of a morbidly adherent placenta, 27.7% for uterine atony and 2.1% for uterine rupture. The median estimated blood loss was 7290 mL. The overall surgical complication rate was 44.6% with bladder injury (19.1%) and sepsis (12.8%) commonest. Intensive care admission was required in 57.4% of women.
  
  
  CONCLUSIONS
  Peripartum hysterectomy is a major procedure carrying a high morbidity rate. In this series, maternal survival was 100%.
authors.affiliation: Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College London, London, UK.
authors.forename: Bryony
authors.initials: B
authors.lastname: Jones
authors.forename: Eko
authors.initials: E
authors.lastname: Zhang
authors.forename: Aisha
authors.initials: A
authors.lastname: Alzouebi
authors.forename: Tanya
authors.initials: T
authors.lastname: Robbins
authors.forename: Sara
authors.initials: S
authors.lastname: Paterson-Brown
authors.forename: Tomas
authors.initials: T
authors.lastname: Prior
authors.forename: Sailesh
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000328:Adult; D001724:Birth Weight; D001803:Blood Transfusion; D003422:Critical Care; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000209:etiology; D007044:Hysterectomy / Q000009:adverse effects; D007231:Infant, Newborn; D050498:Live Birth; D008131:London; D008297:Male; D058725:Peripartum Period; D010921:Placenta Accreta / Q000601:surgery*; D006473:Postpartum Hemorrhage / Q000601:surgery* / Q000628:therapy; D011247:Pregnancy; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology; D062606:Tertiary Care Centers; D001743:Urinary Bladder / Q000293:injuries; D014593:Uterine Inertia / Q000601:surgery*; D014597:Uterine Rupture / Q000601:surgery*; D055815:Young Adult
keywords: caesarean section; hysterectomy; placenta accreta; postpartum haemorrhage