Peripartum hysterectomy and cesarean delivery: a population‐based study

Stivanello, Elisa; Knight, Marian; Dallolio, Laura; Frammartino, Brunella; Rizzo, Nicola; Fantini, Maria Pia

doi:10.3109/00016340903508627

Cited by 36 publications

(36 citation statements)

References 24 publications

(35 reference statements)

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“…10 It is known from multiple studies, that caesarean section is associated with an increased risk of EPH. [11][12][13][14][15][16][17][18] This was confirmed by a recent systematic review from de la Cruz et al 1 The authors identified that Caesarean section, either as a previous history or as the current mode of delivery, was strongly and consistently associated with an increased risk of EPH. 1 Stanco et al reported that 43.4% of their emergency hysterectomies were done because of uterine atony, while 33.9% were due to placenta previa with accreta .19 A study from the same institution in 1993 stated that their primary indication was placenta accreta, the problem in 45% of cases, followed by uterine atony, with 20%.…”

Section: 2supporting

confidence: 59%

Obstetric hysterectomy: an emergency lifesaving procedure

Satia

2016

Int J Reprod Contracept Obstet Gynecol

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Background:Although rare in modern obstetrics, emergency peripartum hysterectomy (EPH) remains a life-saving procedure, in the event of uncontrollable postpartum hemorrhage. Observations regarding the causes and outcomes of EPH provide valuable insights relevant to the current management perspectives in obstetrics. This study is intended to assess the contemporary prevalence, indications, and outcomes of EPH, at a Tertiary care referral institute. Methods: A descriptive observational study was conducted as a retrospective analysis of patient-records, over a span of 3 years January 2011-December 2013, in the department of obstetrics and gynecology, at the KEM hospital, in Mumbai. Cases of EPH were analyzed for information, maternal age, parity, gestational age, type of delivery, indications for EPH and outcomes of the procedure. Results: The average annual incidence rate was1 per 1000 deliveries. 44% of the cases had an indication of abnormal placentation. 60% of the cases had caesarean section deliveries. Multiparity, previous LSCS, and gestation period of <37 weeks, were the commonly observed associations. 52% of cases required ICU admission. Maternal mortality rate was 8%. 20% of the cases had intrauterine fetal death. Conclusions: Abnormal placentation was evident as the leading cause of uncontrollable hemorrhage. This is possibly in view of a continual improvement in the management of uterine atony, reduced incidence of uterine rupture, and importantly, a rising trend of caesarean section delivery. This calls for more thoughtful considerations, regarding decisions for caesarean section delivery, in obstetrics practice.

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Section: 2supporting

confidence: 59%

Obstetric hysterectomy: an emergency lifesaving procedure

Satia

2016

Int J Reprod Contracept Obstet Gynecol

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“…All three Canadian studies reported incidence rates less than 1.0 per 1000 deliveries [11][12][13]. The 22 studies conducted in Europe also had incidence rates under 1.0 per 1000 [2,4,5,9,[14][15][16][17][18][19][20][21][22][23][24][25] except for four studies in Italy, Austria and Greece [26][27][28][29]. Two studies conducted in Oceania reported incidence rates less than 1.0 per 1000 deliveries [30,31].…”

Section: Incidence Of Emergency Peripartum Hysterectomymentioning

confidence: 96%

Cesarean section and the risk of emergency peripartum hysterectomy in high-income countries: a systematic review

Cruz

Thompson

O’Rourke

et al. 2015

Arch Gynecol Obstet

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Introduction Our objective was to determine the incidence and mortality rates associated with emergency peripartum hysterectomy, factors that lead to uncontrolled hemorrhage and emergency peripartum hysterectomy, and to determine the relationship between cesarean section and risk of emergency peripartum hysterectomy. Materials and methods Studies published between January 1, 2000 and December 31, 2012 were identified using PubMed, OVID and Web of Science databases. Studies were included if they reported incidence rates for emergency peripartum hysterectomy, factors that lead to hemorrhage and emergency peripartum hysterectomy, or the association of emergency peripartum hysterectomy with cesarean section in high-income countries. Results Four hundred and fifty-one studies were identified, and 52 were included. The incidence of emergency peripartum hysterectomy ranged from 0.20 to 5.09 per 1000 deliveries with a median incidence rate of 0.61 per 1000 deliveries. These rates have increased over time. Rates varied by region/country, specifically with the United States reporting higher rates than North American, Asian, Oceania, and European countries. The most common factor leading to emergency peripartum hysterectomy was placental abnormalities. Both cesarean section and prior cesarean section were strong risk factors for emergency peripartum hysterectomy with higher risks conferred for each additional cesarean section. The mean percentage of maternal deaths for EPH survivors was 3.0 %. Conclusion Given the association of cesarean section with emergency peripartum hysterectomy, the increased risk of emergency peripartum hysterectomy should be factored into the decision of whether to proceed with cesarean delivery, particularly for women who desire more children.

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“…O risco de morte materna é superior 7 , bem como a ocorrência de infecção, quadros hemorrágicos 8 , acidentes anestésicos 9 , histerectomia pós-parto 10 , ruptura uterina 7,11 , que tornam a morbidade materna relativamente mais acentuada do que no parto vaginal 12 . Complicações tardias, principalmente as relacionadas à placenta prévia e os graus variados de acretismo, estão diretamente relacionadas ao antecedente de cesárea 13,14 .…”

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Impacto do parto vaginal após uma cesárea prévia sobre os resultados perinatais

Madi¹,

Deon²,

Rombaldi³

et al. 2013

Rev. Bras. Ginecol. Obstet.

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Resumo OBJETIVO: Analisar o impacto do parto vaginal, após uma cesárea prévia, sobre os resultados perinatais. MÉTODOS: Estudo caso-controle, com seleção de casos incidentes e controles consecutivos, no qual foram analisadas variáveis maternas e perinatais. Compararam-se gestantes secundigestas com parto cesáreo prévio (n=375) e que deram à luz via transpélvica (PVPC), com gestantes com os mesmos critérios de inclusão, mas submetidas a operação cesariana (PCPC, n=375). Foram considerados critérios de inclusão: gestantes secundigestas que tenham dado à luz por meio de parto cesariana na gestação anterior; gestação única e de termo; feto em apresentação cefálica, sem malformação congênita; ausência de placenta prévia ou qualquer tipo de sangramento de terceiro trimestre gestacional. RESULTADOS: No estudo, a taxa de PVPC foi de 45,6%, sendo que 20 deles (5,3%) foram ultimados com o fórceps. Observou-se associação significante entre PVPC e idade materna inferior a 19 anos (p<0,01), etnia caucasiana (p<0,05), número médio de consultas de pré-natal (p<0,001), tempo de ruptura prematura das membranas (p<0,01), tempo de trabalho de parto inferior a 12h (p<0,045), índice de Apgar inferior a sete no 5º minuto (p<0,05), tocotraumatismo fetal (p<0,01) e anoxia (p<0,006). No grupo de recém-nascidos por PCPC observou-se maior frequência de taquipneia transitória (p<0,014), disfunções respiratórias (p<0,04) e maior tempo de internação na unidade de tratamento intensivo neonatal (p<0,016). Houve apenas um caso de ruptura uterina no grupo PVPC. O número de neomortos foi idêntico em ambos os grupos. CONCLUSÕES: A via de parto vaginal em secundigestas com cesárea prévia associou-se a aumento significativo da morbidade neonatal. Serão necessários mais estudos para elaborar estratégias que visem melhorias dos resultados perinatais e de auxílio aos profissionais, de forma que estes possam melhor orientar as suas pacientes na escolha da via de parto mais adequada. Abstract PURPOSE:To analyze the impact of vaginal delivery after a previous cesarean section on perinatal outcomes. METHODS: Case-control study with selection of incident cases and consecutive controls. Maternal and perinatal variables were analyzed. We compared secundiparas who had a vaginal delivery after a previous cesarean delivery (VBAC) (n=375) with secundiparas who had a second cesarean section (CS) (n=375). Inclusion criteria were: secundiparas who underwent a cesarean section in the previous pregnancy; singleton and term pregnancy; fetus in vertex presentation, with no congenital malformation; absence of placenta previa or any kind of bleeding in the third quarter of pregnancy. RESULTS: The rate of vaginal delivery was 45.6%, and 20 (5.3%) women had forceps deliveries. We found a significant association between VBAC and mothers younger than 19 years (p<0.01), Caucasian ethnicity (p<0.05), mean number of prenatal care visits (p<0.001), time of premature rupture of membranes (p<0.01), labor duration shorter than 12 hours (p<0.04), Apgar score lower than seven at 5th m...

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Peripartum hysterectomy and cesarean delivery: a population‐based study

Cited by 36 publications

References 24 publications

Obstetric hysterectomy: an emergency lifesaving procedure

Obstetric hysterectomy: an emergency lifesaving procedure

Cesarean section and the risk of emergency peripartum hysterectomy in high-income countries: a systematic review

Impacto do parto vaginal após uma cesárea prévia sobre os resultados perinatais

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