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Am J Obstet Gynecol. 2012 Jan;206(1):63.e1-8. doi: 10.1016/j.ajog.2011.07.030. Epub 2011 Jul 22.

Peripartum hysterectomy in the United States: nationwide 14 year experience.

Author information

1
Division of Obstetric Anesthesia, Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, 02114, USA. bbateman@partners.org

Abstract

OBJECTIVE:

The objective of the study was to examine the trends in the rate of peripartum hysterectomy and the contribution of changes in maternal characteristics to these trends.

STUDY DESIGN:

This was a cross-sectional study of peripartum hysterectomy identified from hospitalizations for delivery recorded in the 1994-2007 Nationwide Inpatient Sample.

RESULTS:

The overall rate of peripartum hysterectomy increased by 15% during the study period. The rate of hysterectomy for abnormal placentation increased by 1.2-fold; adjustment for previous cesarean delivery explained nearly all of this increase. The rate of hysterectomy for uterine atony following repeat cesarean delivery increased nearly 4-fold, following primary cesarean delivery approximately 2.5-fold, and following vaginal delivery about 1.5-fold. This fast growing trend in peripartum hysterectomy secondary to uterine atony was also largely explained by increasing rates of primary and repeat cesareans.

CONCLUSION:

Rates of peripartum hysterectomy increased substantially in the United States from 1994 to 2007; much of this increase was due to rising rates of cesarean delivery.

PMID:
21982025
DOI:
10.1016/j.ajog.2011.07.030
[Indexed for MEDLINE]
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