Changing Patterns of Peripartum Hysterectomy Over Time

Fleming, Elaine; Yule, Casey S.; Lafferty, Ashlyn; Happe, Sarah K.; McIntire, Donald D.; Spong, Catherine Y.

doi:10.1097/aog.0000000000004572

Cited by 6 publications

(7 citation statements)

References 6 publications

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“…This study presents the prevalence of PH at a regional tertiary medical center and a teaching hospital. At our center, the incidence of PH was higher than that reported in mainland China in 2011 8 but lower than that reported in other centers 2,9 during the same period.…”

Section: Discussioncontrasting

confidence: 73%

“…An upward trend in CS-related PH has also been reported in other studies. 1,2,10 One explanation for this is the higher PH incidence in CS compared with vaginal delivery. 11,12 At our center, the high CS rate remains an urgent problem.…”

Section: Discussionmentioning

confidence: 99%

“…It is also associated with maternal morbidity and mortality, and significantly affects the quality of life of women with fertility issues. The incidence of PH varies between different countries and regions 1,2 . We reviewed several studies and found an increasing tendency in the rate of PH as well as a change in the indications for PH.…”

Section: Introductionmentioning

confidence: 96%

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Reflections on peripartum hysterectomy: A 10‐year retrospective observational study in Northeast China

Wang,

Zhang

2023

Intl J Gynecology & Obste

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ObjectiveTo explore the change trends in incidence and leading factors to peripartum hysterectomy (PH) at a regional tertiary medical center in northeast China.MethodsThis was a retrospective observational study of all PH cases conducted at Shengjing Hospital between January 1, 2012 and December 31, 2021. Information on maternal characteristics of pregnancy and delivery, indications of PH, inventions before hysterectomy, complications, and maternal and neonatal outcomes obtained from the Shengjing Hospital Information System were analyzed.ResultsAmong a total of 157 553 deliveries, there were 127 cases of PH (overall PH incidence: 0.85/1000 deliveries); 120 patients (94.49%) underwent hysterectomy after cesarean section, and seven (5.51%) underwent vaginal delivery (P < 0.001). Abnormal placentation was the leading indication for PH (101, 79.53%), including placenta previa (PP) with placenta accreta spectrum (PAS) (93, 73.23%), PP alone (5, 3.94%), and PAS alone (3, 2.36%). Among the patients who underwent PH with abnormal placentation, 92.08% had at least one cesarean section (P < 0.001) and 20.19% had bladder injury (P = 0.044). All maternal deaths (n = 2) occurred in referral patients, and the maternal mortality rate was 1.57/100 hysterectomies.ConclusionAbnormal placentation was the primary indication for PH. For such patients, adequate assessment of their condition and complete communication are strongly recommended. The identification of high‐risk groups for postpartum hemorrhage, timely and effective rescue, and referral are equally important for avoiding PH.

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Section: Discussioncontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

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Reflections on peripartum hysterectomy: A 10‐year retrospective observational study in Northeast China

Wang,

Zhang

2023

Intl J Gynecology & Obste

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“…The rise in peripartum hysterectomy in the US has occurred concomitantly with increasing rates of cesarean delivery and placenta accreta spectrum disorders. Subsequently, the predominant indication for peripartum hysterectomy has shifted from uterine atony to placenta disorders [7,11]. Risk factors for placental disorders include a previous cesarean delivery, with each successive cesarean compounding an individual's risk [12].…”

Section: Introductionmentioning

confidence: 99%

“…Previous literature has demonstrated an association between race/ethnicity and peripartum hysterectomy [22][23][24][25], and evaluated trends over time [2,11,22,26]. However, these studies do not assess potential temporal variation in hysterectomy rates or investigate factors that may contribute to race/ethnicity-specific trends.…”

Section: Introductionmentioning

confidence: 99%

Temporal trends in peripartum hysterectomy among individuals with a previous cesarean delivery by race/ethnicity in the United States: A population-based cohort study

Rajasingham,

Hossein Pour,

Scattolon

et al. 2024

PLoS ONE

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Objectives Rates of severe maternal morbidity have highlighted persistent and growing racial disparities in the United States (US). We aimed to contrast temporal trends in peripartum hysterectomy by race/ethnicity and quantify the contribution of changes in maternal and obstetric factors to temporal variations in hysterectomy rates. Methods We conducted a population-based, retrospective study of 5,739,569 US residents with a previous cesarean delivery, using National Vital Statistics System’s Natality Files (2011–2021). Individuals were stratified by self-identified race/ethnicity and classified into four periods based on year of delivery. Temporal changes in hysterectomy rates were estimated using odds ratios (ORs) and 95% confidence intervals (CIs). We used sequential logistic regression models to quantify the contribution of maternal and obstetric factors to temporal variations in hysterectomy rates. Results Over the study period, the peripartum hysterectomy rate increased from 1.23 (2011–2013) to 1.44 (2019–2021) per 1,000 deliveries (OR 2019–2021 vs. 2011–2013 = 1.17, 95% CI 1.10 to 1.25). Hysterectomy rates varied by race/ethnicity with the highest rates among Native Hawaiian and Other Pacific Islander (NHOPI; 2.73 per 1,000 deliveries) and American Indian or Alaskan Native (AIAN; 2.67 per 1,000 deliveries) populations in 2019–2021. Unadjusted models showed a temporal increase in hysterectomy rates among AIAN (2011–2013 rate = 1.43 per 1,000 deliveries; OR 2019–2021 vs. 2011–2013 = 1.87, 95% CI 1.02 to 3.45) and White (2011–2013 rate = 1.13 per 1,000 deliveries; OR 2019–2021 vs. 2011–2013 = 1.21, 95% CI 1.11 to 1.33) populations. Adjustment ranged from having no effect among NHOPI individuals to explaining 14.0% of the observed 21.0% increase in hysterectomy rates among White individuals. Conclusion Nationally, racial disparities in peripartum hysterectomy are evident. Between 2011–2021, the rate of hysterectomy increased; however, this increase was confined to AIAN and White individuals.

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Postpartum Hemorrhage

Nelson

2023

Queenan's Management of High‐Risk Pregnancy

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Changing Patterns of Peripartum Hysterectomy Over Time

Abstract: The incidence of peripartum hysterectomy is increasing and is related to the increasing incidence of placenta accreta spectrum.

Cited by 6 publications

References 6 publications

Reflections on peripartum hysterectomy: A 10‐year retrospective observational study in Northeast China

Reflections on peripartum hysterectomy: A 10‐year retrospective observational study in Northeast China

Temporal trends in peripartum hysterectomy among individuals with a previous cesarean delivery by race/ethnicity in the United States: A population-based cohort study

Postpartum Hemorrhage

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