Changing trends in peripartum hysterectomy over the last 4 decades.
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Authors
Flood, Karen MSaid, 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.Issue Date
2012-02-01T10:37:51ZMeSH
Cesarean SectionCohort Studies
Female
Humans
Hysterectomy/*trends
Intraoperative Period
Obstetric Labor Complications/*surgery
Postpartum Period
Pregnancy
Puerperal Disorders/*surgery
Retrospective Studies
Time Factors
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Am J Obstet Gynecol. 2009 Jun;200(6):632.e1-6.Journal
American journal of obstetrics and gynecologyDOI
10.1016/j.ajog.2009.02.001PubMed ID
19306969Abstract
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
engISSN
1097-6868 (Electronic)0002-9378 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1016/j.ajog.2009.02.001