Surveillance and case control study of peripartum hysterectomy
Emergency hysterectomy in the peripartum period is often performed for life-threatening obstetric complications. The operation is considered to be one of the most major complications in obstetrics and is related to significant maternal mortality and morbidity. Studies report between 10 and 20-fold increases in the incidence of emergency peripartum hysterectomy in women who have had a previous delivery by caesarean section compared to those who have not. This finding is of particular concern in the context of rising UK rates of caesarean delivery. This study documented that the incidence of peripartum hysterectomy was 4.1 cases per 10,000 births (95% CI 3.6-4.5). Maternal mortality was 0.6% (95% CI 0-1.5%). Peripartum hysterectomy was strongly associated with previous delivery by caesarean section and the risk rises with increasing number of previous caesarean section deliveries. Maternal age and parity were also important risk factors.