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
2009-06MeSH
Cesarean SectionCohort Studies
Female
Humans
Hysterectomy
Intraoperative Period
Obstetric Labor Complications
Postpartum Period
Pregnancy
Puerperal Disorders
Retrospective Studies
Time Factors
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Changing trends in peripartum hysterectomy over the last 4 decades. 2009, 200 (6):632.e1-6 Am. J. Obstet. Gynecol.Journal
American journal of obstetrics and gynecologyDOI
10.1016/j.ajog.2009.02.001PubMed ID
19306969Additional Links
http://www.ajog.org/article/S0002-9378(09)00186-0/abstractAbstract
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.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.
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).
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.
Item Type
ArticleLanguage
enISSN
1097-6868ae974a485f413a2113503eed53cd6c53
10.1016/j.ajog.2009.02.001
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