Peripartum hysterectomy in the United States: nationwide 14 year experience

Am J Obstet Gynecol. 2012 Jan;206(1):63.e1-8. doi: 10.1016/j.ajog.2011.07.030. Epub 2011 Jul 22.

Abstract

Objective: The objective of the study was to examine the trends in the rate of peripartum hysterectomy and the contribution of changes in maternal characteristics to these trends.

Study design: This was a cross-sectional study of peripartum hysterectomy identified from hospitalizations for delivery recorded in the 1994-2007 Nationwide Inpatient Sample.

Results: The overall rate of peripartum hysterectomy increased by 15% during the study period. The rate of hysterectomy for abnormal placentation increased by 1.2-fold; adjustment for previous cesarean delivery explained nearly all of this increase. The rate of hysterectomy for uterine atony following repeat cesarean delivery increased nearly 4-fold, following primary cesarean delivery approximately 2.5-fold, and following vaginal delivery about 1.5-fold. This fast growing trend in peripartum hysterectomy secondary to uterine atony was also largely explained by increasing rates of primary and repeat cesareans.

Conclusion: Rates of peripartum hysterectomy increased substantially in the United States from 1994 to 2007; much of this increase was due to rising rates of cesarean delivery.

MeSH terms

  • Adult
  • Cesarean Section / statistics & numerical data
  • Cesarean Section / trends
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hysterectomy / statistics & numerical data*
  • Hysterectomy / trends
  • Obstetric Labor Complications / epidemiology
  • Obstetric Labor Complications / surgery
  • Peripartum Period*
  • Pregnancy
  • Pregnancy Complications / epidemiology
  • Pregnancy Complications / surgery
  • Prevalence
  • Treatment Outcome
  • United States / epidemiology
  • Uterine Inertia / surgery
  • Young Adult