Abstract
To determine the indications and outcomes of peripartum hysterectomies performed at Hospital de Clínicas de Porto Alegre (a university hospital in Southern Brazil) during the past 15 years, and to analyze the clinical characteristics of the women submitted to this procedure. A cross-sectional study of 47 peripartum hysterectomies from 2005 to 2019. The peripartum hysterectomies performed in our hospital were indicated mainly due to placenta accreta or suspicion thereof (44.7% of the cases), puerperal hemorrhage without placenta accreta (27.7%), and infection (25.5%). Total hysterectomies accounted for 63.8% of the cases, and we found no difference between total versus subtotal hysterectomies in the studied outcomes. Most hysterectomies were performed within 24 hours after delivery, and they were associated with placenta accreta, placenta previa, and older maternal age. Most (66.0%) patients were admitted to the intensive care unit (ICU). Those who did not need it were significantly older, and had more placenta accreta, placenta previa, or previous Cesarean delivery.
Highlights
In the history of Obstetrics, Horatio Storer performed the first hysterectomy on a gravid uterus in a live woman in 1869 due to a hemorrhage caused by a uterine tumor.1 The role of peripartum hysterectomy has changed ever since
Other risk factors are placenta previa, advanced maternal age, twin pregnancy, chorioamnionitis, and puerperal infections
Considering that 54,617 births occurred in this period, we estimate a rate of 0.87 peripartum hysterectomies per 1,000 births
Summary
In the history of Obstetrics, Horatio Storer performed the first hysterectomy on a gravid uterus in a live woman in 1869 due to a hemorrhage caused by a uterine tumor. The role of peripartum hysterectomy has changed ever since. In the history of Obstetrics, Horatio Storer performed the first hysterectomy on a gravid uterus in a live woman in 1869 due to a hemorrhage caused by a uterine tumor.. Peripartum hysterectomy is performed mainly in cases of abnormal placentation (predominantly placenta accreta) or life-threatening hemorrhage.. A meta-analysis of 128 studies from low- to high-income countries estimated a weighted average of 0.9 peripartum hysterectomies per 1,000 births, and a maternal mortality rate of 5.2% after this procedure. Both primary or repeat Cesarean sections are significantly associated with an increased risk of peripartum hysterectomy, due to abnormal placentation, and due to uterine atony.. Both primary or repeat Cesarean sections are significantly associated with an increased risk of peripartum hysterectomy, due to abnormal placentation, and due to uterine atony. Other risk factors are placenta previa (which is significantly associated with an increased likelihood of placenta accreta), advanced maternal age, twin pregnancy, chorioamnionitis, and puerperal infections.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
