Postpartum Hysterectomy Indications of a Tertiary Referral Center

Abstract

Aim of the study is to determine the incidence, indications, risk factors, results of pathological investigations and outcomes of peripartum hysterectomies in a tertiary referral center. Material and Methods: We conducted a retospective review of 125 postpartum hysterectomy cases between 2009 and 2013. Hysterectomy Indications, way of delivery, demographic data of patients, complications and results of pathologic eveluation were studied. Statistical analyses for vaginal delivery and caesarean section was performed. Results: The frequency of total postpartum hysterectomy was found 1,19 in one thousands live birth during the study period. This rate was found 3 and 0.13 for caesarean section and vaginal birth respectively. The frequency of postpartum hysterectomy of patients who have gone to caesarean section while vaginal birth was being planned, was found 0.04 (5/104256) in all one thousands live birth. The indications for hysterectomy was uterine atony (17.6%), placenta previa (20.8%), placenta accreta (8.8%), placenta percreta (36.8%), placenta increta (12%) and uterine rupture (4%). Placenta invasion anomalies and uterine rupture were found significantly more frequent in caesarean section than vaginal birth (p<0.001). Conclusion: Emergency postpartum hysterectomy remains a life-saving surgical intervention. Clinicians should be alert for postpartum bleeding especially with previous caesarean sections.