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    Changing trends in peripartum hysterectomy over the last 4 decades.

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    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.
    Issue Date
    2009-06
    MeSH
    Cesarean Section
    Cohort Studies
    Female
    Humans
    Hysterectomy
    Intraoperative Period
    Obstetric Labor Complications
    Postpartum Period
    Pregnancy
    Puerperal Disorders
    Retrospective Studies
    Time Factors
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    Citation
    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 gynecology
    URI
    http://hdl.handle.net/10147/129780
    DOI
    10.1016/j.ajog.2009.02.001
    PubMed ID
    19306969
    Additional Links
    http://www.ajog.org/article/S0002-9378(09)00186-0/abstract
    Abstract
    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
    Article
    Language
    en
    ISSN
    1097-6868
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ajog.2009.02.001
    Scopus Count
    Collections
    Rotunda Hospital

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