Incidence, indications, and risk factors of postpartum hysterectomy

Abstract

Objective: To report the incidence rate of postpartum hysterectomy (PH) within six weeks postpartum and its indications, complications, and risk factors in Rasht, North of Iran Design: Case-control study using patients' documents of the period 2002–2013 Setting: Al-Zahra maternity hospital - the only tertiary maternity hospital in Rasht, North of Iran Subjects: Seventy-eight patients consisting of 26 PH cases and 52 subjects of control group were studied. Main outcome measure(s): Risk factors of PH Results: The incidence rate of PH was 0.05%. The most common indication for PH was placenta previa (12/26, 46.2%). Cesarean delivery was significantly higher in case group (N = 22, 84.6%) than in control group (N = 30, 57.7%) (P = 0.022). Delivery method for 9 (75%) cases with placenta previa was cesarean section. Mean age (P = 0.003), gravidity (P = 0.001), parity (P = 0.0001), and number of previous cesarean deliveries (P = 0.0001) were significantly higher in case group. In logistic regression analysis, only number of previous cesarean section significantly increased the incidence of PH (OR: 5.408, 95% Cl: 1.989 to 14.702). Transfusion was significantly higher in case group (P =0001). One woman with hysterectomy (3.8%) was admitted to the intensive care unit. Mortality was occurred in one (3.8%) patient in PH group. Conclusion: Placenta previa is the major indication for PH and should be considered by delivery assistants and clinicians. In cases with history of previous cesarean section, the risk of PH should be considered. Policy makers should attempt to design effective programs for reducing cesarean section rates. Show more