Risk of peripartum hysterectomy by mode of delivery and prior obstetric history: Data from a population-based study

Michail Spiliopoulos, Aparna Kareti, Neetu J. Jain, Lakota K. Kruse, Alex Hanlon, Vani Dandolu

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Purpose: To provide an estimate of the incidence of peripartum hysterectomy in the state of New Jersey and calculate the effect of mode of delivery and prior obstetric history. Methods: A perinatal-linked dataset provided by the Maternal Child Health Epidemiology Program in the New Jersey Department of Health was used to obtain information from birth certificates and hospital discharge records. Using multivariate logistic regression, various demographic and clinical factors were assessed for association with peripartum hysterectomy. Results: A total of 1,004,116 births were identified between 1997 and 2005 and 853 peripartum hysterectomies were performed (0.85/1,000 deliveries). Parity increased the risk of hysterectomy with nulliparous women having approximately half the risk compared to multiparous women. Cesarean delivery with no previous c-section almost doubled the risk (OR 2.20, CI 1.80-26.69) while in the presence of a previous c-section the risk was almost four times higher (OR 4.51, CI 3.76-5.40). Operative vaginal delivery did not result in any increase in the risk. Conclusions: Mode of delivery and prior obstetric history are major risk factors for peripartum hysterectomy. Patients desiring cesarean delivery need to be counseled on the risk of this serious complication.

Original languageEnglish (US)
Pages (from-to)1261-1268
Number of pages8
JournalArchives of gynecology and obstetrics
Volume283
Issue number6
DOIs
StatePublished - Jun 2011
Externally publishedYes

Keywords

  • C-section
  • Peripartum hysterectomy
  • Placenta previa
  • Population-based study

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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