Peripartum hysterectomy-incidence and maternal morbidity

Background. The aim of the study was to find the incidence and clinical implications of peripartum hysterectomy in our department and to identify women at risk to improve treatment before resorting to hysterectomy. Material and methods. In the period 1981-1996, cases with peripartum hysterectomy among a total of 70,546 deliveries in our department were identified from three different sources. The clinical variables were obtained by review of the maternal records. Results. In the study period, 11 cases, representing an incidence of 0.2 peripartum hysterectomies per 1000 deliveries was found. Eight women had a cesarean section and three women had a spontaneous vaginal delivery. Six of the patients had previous operation on the uterus. The indication for hysterectomy was atony in seven, suspected rupture in two, placenta accreta in one and DIC in one woman. The maternal morbidity was substantial as the mean number of transfusions given was 15 units (range 7-24), and the mean hospitalization time was 15 days (range 11-29). There was no maternal mortality, but one infant died due to asphyxia caused by placental abruption. Conclusions. The incidence of peripartum hysterectomy was low, but the condition is serious with significant maternal morbidity.