Incidence and associated risk factors of peripartum hysterectomy.

ABSTRACT

We present a descriptive study of 86 pregnant women, who underwent peripartum hysterectomy at Siriraj Hospital between 1982 and 1992. The incidence was 0.5 per 1,000 deliveries. The indications leading to hysterectomy were uterine atony, uterine rupture, placenta previa, placenta accrete, tear bleeding, and uterine infection. Common complications were haemorrhage and infection. There were 6 maternal deaths (7%) from severe hemorrhage and all of them evinced coagulopathy. Furthermore, there were 9 fetal deaths (10.5%), 2 of them having congenital anomalies. This study indicates that lack of antenatal care, advanced maternal age multiparity, and abnormal delivery are the risk factors for peripartum hysterectomy. To reduce the prevalence and risk of peripartum hysterectomy; parity, appropriate maternal age at pregnancy, high quality antenatal care and good intrapartum care are factors to consider.