Incidence and risk factors of emergency cesarean hysterectomy.

ABSTRACT

To identify risk factors associated with emergency cesarean hysterectomy at Siriraj Hospital, medical records of 93 patients who underwent emergency cesarean hysterectomy from January 1986 through December 1995 were retrospectively compared with those of 372 selected controls who underwent cesarean section at the time close to the first group (case control = 14). The incidence of emergency cesarean hysterectomy during the period was 4.07 / 1,000 cesarean sections. Multivariable analysis revealed that age > 35 years (OR=9.7,95% CI 3.7-24.9), placenta preview (OR = 4.8, 95% CI 2.2-10.6), age 31-34 years (OR=4.3,95% CI 1.7-11.3) and parity >3 (OR=3.4,95% CI 1.6-7.1) were independent factors significantly associated with emergency cesarean hysterectomy (P<0.01). Emergency cesarean hysterectomy remains a necessary procedure for life saving during abdominal delivery. Identification of patients at risk, knowledge of this operation and skill at its performance can be very helpful in reducing maternal morbidity and mortality.