Emergency peripartum hysterectomy: 2-year experiences in non-tertiary center.
OBJECTIVE
The aim of this study was to evaluate risk factors, indications and materno-fetal outcomes for emergency peripartum hysterectomy.


METHODS
Retrospective evaluation was made of 23 cases. Maternal and neonatal outcomes, need for referral to the tertiary center and related complications were compared to those at the initial diagnosis for surgery, location of delivery, type of surgery and the admission diagnosis. The risk factors associated with emergency peripartum hysterectomy were also investigated. Significance was evaluated at p values of <0.01 and <0.05.


RESULTS
There was a correlation between peripartum hysterectomy and uterine atony or uterine rupture (p < 0.01). The referral rates of patients with home delivery were significantly higher than those of patients who delivered in hospital (p = 0.02) but no significant difference was observed in the neonatal outcomes (p = 0.38). There was no significant difference in the rates of maternal complications between home and hospital delivery (p = 0.068). According to the indication for surgery, no significant difference was observed between the rates of referral to the tertiary center, maternal outcomes, complications, or need for maternal intensive care (p > 0.05). However, a highly significant difference was observed between the neonatal outcomes (p = 0.001).


CONCLUSIONS
The results of this study showed the most important risk factors associated with peripartum hysterectomy to be uterine atony, grand multiparity, and uterine rupture. Maternal intensive care, maternal death, neonatal death, or neonatal intensive care were associated with home delivery or delayed presentation at hospital.
Departments of Obstetrics and Gynecology, Bakirkoy Dr Sadi Konuk Teaching and Research Hospital, Tevfik Saglam Street, No: 11, Zuhuratbaba, Bakirkoy, 34147, Istanbul, Turkey. dr.baki77@gmail.com.
Mehmet B
MB
Senturk
Department of Obstetrics and Gynecology, Batman State Hospital, Batman, Turkey.
Yusuf
Y
Cakmak
Departments of Obstetrics and Gynecology, Bakirkoy Dr Sadi Konuk Teaching and Research Hospital, Tevfik Saglam Street, No: 11, Zuhuratbaba, Bakirkoy, 34147, Istanbul, Turkey.
Hakan
H
Guraslan
Departments of Obstetrics and Gynecology, Bakirkoy Dr Sadi Konuk Teaching and Research Hospital, Tevfik Saglam Street, No: 11, Zuhuratbaba, Bakirkoy, 34147, Istanbul, Turkey.
Keziban
K
Dogan
D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D003422:Critical Care; D036861:Delivery, Obstetric; D004630:Emergencies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000401:mortality; D015994:Incidence; D008428:Maternal Mortality; D010298:Parity; D058725:Peripartum Period; D006473:Postpartum Hemorrhage / Q000209:etiology; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology; D014593:Uterine Inertia / Q000453:epidemiology; D014597:Uterine Rupture / Q000453:epidemiology
Hysterectomy; Multiparity; Uterine atony; Uterine rupture