Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan;43(1):3-8.
doi: 10.1055/s-0040-1721354. Epub 2021 Jan 29.

Peripartum Hysterectomies over a Fifteen-year Period

Alessandra Dorigon  1 , Sérgio Hofmeister Martins-Costa  1   2 , José Geraldo Lopes Ramos  1   2
Affiliations

Peripartum Hysterectomies over a Fifteen-year Period

Alessandra Dorigon et al. Rev Bras Ginecol Obstet. 2021 Jan.

Abstract
in English, Portuguese

Objective: 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.

Methods: A cross-sectional study of 47 peripartum hysterectomies from 2005 to 2019.

Results: 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.

Conclusion: 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.

Objetivo: Determinar as indicações e os desfechos das histerectomias periparto realizadas no Hospital de Clínicas de Porto Alegre nos últimos 15 anos, bem como analisar as características clínicas das mulheres submetidas a esse procedimento. MéTODOS: Estudo transversal de 47 histerectomias periparto realizadas no período de 2005 a 2019.

Resultados: Em nosso hospital, as histerectomias periparto foram indicadas principalmente por acretismo placentário ou sua suspeita (44,7% dos casos), hemorragia puerperal sem acretismo placentário (27,7%), e infecção (25,5%). Histerectomias totais corresponderam a 63,8% dos casos, e não encontramos diferença entre histerectomia total e subtotal para os desfechos estudados. A maioria das histerectomias foi realizada dentro de 24 horas após o parto, o que estava associado a acretismo placentário, placenta prévia, e idade materna mais avançada. CONCLUSãO: A maioria (66,0%) das mulheres necessitou de internação em unidade de terapia intensiva (UTI); aquelas que não necessitaram eram significativamente mais velhas, e tinham mais acretismo placentário, placenta prévia, ou cesárea prévia.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflict of interests to declare.

Figures

Fig. 1
Fig. 1
Timeline of peripartum hysterectomies.
See this image and copyright information in PMC

References

    1. Durfee R B. Evolution of cesarean hysterectomy. Clin Obstet Gynecol. 1969;12(03):575–589. doi: 10.1097/00003081-196909000-00002. - DOI - PubMed
    1. Davis M E. Complete cesarean hysterectomy; a logical advance in modern obstetric surgery. Am J Obstet Gynecol. 1951;62(04):838–853. doi: 10.1016/0002-9378(51)90174-3. - DOI - PubMed
    1. van den Akker T, Brobbel C, Dekkers O M, Bloemenkamp K W. Prevalence, indications, risk indicators, and outcomes of emergency peripartum hysterectomy worldwide: a systematic review and meta-analysis. Obstet Gynecol. 2016;128(06):1281–1294. doi: 10.1097/AOG.0000000000001736. - DOI - PubMed
    1. de la Cruz C Z, Thompson E L, O'Rourke K, Nembhard W N. Cesarean section and the risk of emergency peripartum hysterectomy in high-income countries: a systematic review. Arch Gynecol Obstet. 2015;292(06):1201–1215. doi: 10.1007/s00404-015-3790-2. - DOI - PubMed
    1. Rossi A C, Lee R H, Chmait R H. Emergency postpartum hysterectomy for uncontrolled postpartum bleeding: a systematic review. Obstet Gynecol. 2010;115(03):637–644. doi: 10.1097/AOG.0b013e3181cfc007. - DOI - PubMed

LinkOut - more resources