Changing trends in peripartum hysterectomy over the last 4 decades.

Hdl Handle:
http://hdl.handle.net/10147/207716
Title:
Changing trends in peripartum hysterectomy over the last 4 decades.
Authors:
Flood, Karen M; Said, Soha; Geary, Michael; Robson, Michael; Fitzpatrick, Christopher; Malone, Fergal D
Affiliation:
Department of Obstetrics and Gynaecology, Rotunda Hospital, Royal College of, Surgeons in Ireland, Dublin, Ireland.
Citation:
Am J Obstet Gynecol. 2009 Jun;200(6):632.e1-6.
Journal:
American journal of obstetrics and gynecology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207716
DOI:
10.1016/j.ajog.2009.02.001
PubMed ID:
19306969
Abstract:
OBJECTIVE: The purpose of this study was to identify changing trends in peripartum hysterectomy (PH) in a single large obstetric population over the last 40 years. STUDY DESIGN: A retrospective cohort study was performed from 1966-2005 of patients who had PH in any of the 3 Dublin obstetric hospitals. Cases were identified, and details were obtained from the combined patient databases of each hospital. RESULTS: There were 872,379 deliveries during the study period, among which 358 women underwent PH (0.4/1000 deliveries). In a comparison of the study decades 1966-1975 with 1996-2005, PH decreased from 0.9 per 1000 deliveries to 0.2 of 1000 deliveries. Although the overall cesarean delivery rate has increased from 6-19% during these 2 decades, the percentage of PH that occurs in the setting of a previous cesarean delivery has increased from 27-57% (P < .00001). Indications for PH have changed significantly in this time period, with "uterine rupture" as the indication for PH decreasing from 40.5-9.3% (P < .0001) and placenta accreta as the indication increasing significantly from 5.4-46.5% (P < .00001). CONCLUSION: PH has decreased over the last 4 decades. However, alongside the rising cesarean delivery rate, there has been a marked increase in the incidence of placenta accreta.
Language:
eng
MeSH:
Cesarean Section; Cohort Studies; Female; Humans; Hysterectomy/*trends; Intraoperative Period; Obstetric Labor Complications/*surgery; Postpartum Period; Pregnancy; Puerperal Disorders/*surgery; Retrospective Studies; Time Factors
ISSN:
1097-6868 (Electronic); 0002-9378 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorFlood, Karen Men_GB
dc.contributor.authorSaid, Sohaen_GB
dc.contributor.authorGeary, Michaelen_GB
dc.contributor.authorRobson, Michaelen_GB
dc.contributor.authorFitzpatrick, Christopheren_GB
dc.contributor.authorMalone, Fergal Den_GB
dc.date.accessioned2012-02-01T10:37:51Z-
dc.date.available2012-02-01T10:37:51Z-
dc.date.issued2012-02-01T10:37:51Z-
dc.identifier.citationAm J Obstet Gynecol. 2009 Jun;200(6):632.e1-6.en_GB
dc.identifier.issn1097-6868 (Electronic)en_GB
dc.identifier.issn0002-9378 (Linking)en_GB
dc.identifier.pmid19306969en_GB
dc.identifier.doi10.1016/j.ajog.2009.02.001en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207716-
dc.description.abstractOBJECTIVE: The purpose of this study was to identify changing trends in peripartum hysterectomy (PH) in a single large obstetric population over the last 40 years. STUDY DESIGN: A retrospective cohort study was performed from 1966-2005 of patients who had PH in any of the 3 Dublin obstetric hospitals. Cases were identified, and details were obtained from the combined patient databases of each hospital. RESULTS: There were 872,379 deliveries during the study period, among which 358 women underwent PH (0.4/1000 deliveries). In a comparison of the study decades 1966-1975 with 1996-2005, PH decreased from 0.9 per 1000 deliveries to 0.2 of 1000 deliveries. Although the overall cesarean delivery rate has increased from 6-19% during these 2 decades, the percentage of PH that occurs in the setting of a previous cesarean delivery has increased from 27-57% (P < .00001). Indications for PH have changed significantly in this time period, with "uterine rupture" as the indication for PH decreasing from 40.5-9.3% (P < .0001) and placenta accreta as the indication increasing significantly from 5.4-46.5% (P < .00001). CONCLUSION: PH has decreased over the last 4 decades. However, alongside the rising cesarean delivery rate, there has been a marked increase in the incidence of placenta accreta.en_GB
dc.language.isoengen_GB
dc.subject.meshCesarean Sectionen_GB
dc.subject.meshCohort Studiesen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshHysterectomy/*trendsen_GB
dc.subject.meshIntraoperative Perioden_GB
dc.subject.meshObstetric Labor Complications/*surgeryen_GB
dc.subject.meshPostpartum Perioden_GB
dc.subject.meshPregnancyen_GB
dc.subject.meshPuerperal Disorders/*surgeryen_GB
dc.subject.meshRetrospective Studiesen_GB
dc.subject.meshTime Factorsen_GB
dc.titleChanging trends in peripartum hysterectomy over the last 4 decades.en_GB
dc.contributor.departmentDepartment of Obstetrics and Gynaecology, Rotunda Hospital, Royal College of, Surgeons in Ireland, Dublin, Ireland.en_GB
dc.identifier.journalAmerican journal of obstetrics and gynecologyen_GB
dc.description.provinceLeinster-

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