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Peripartum hysterectomy in Taiwan
Author(s) -
Jou HeiJen,
Hung HsinWen,
Ling PeiYing,
Chen ShihMing,
Wu ShiaoChi
Publication year - 2008
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2007.12.004
Subject(s) - medicine , placenta previa , obstetrics , odds ratio , hysterectomy , gestational diabetes , gynecology , retrospective cohort study , confidence interval , singleton , cesarean delivery , incidence (geometry) , pregnancy , vaginal delivery , uterine rupture , placenta , gestation , fetus , uterus , surgery , genetics , physics , pathology , optics , biology
Objective To investigate the incidence and associated risk factors for peripartum hysterectomy in singleton pregnancies. Methods A retrospective cohort study of all women with singleton pregnancies admitted for delivery in 2002 taken from the National Healthcare Insurance database. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for maternal and hospital characteristics using logistic regression. Results There were 287 peripartum hysterectomies in 214 237 singleton pregnancies (0.13%). Cesarean delivery, vaginal birth after cesarean (VBAC), and repeat cesarean delivery had higher hysterectomy rates than vaginal delivery, with adjusted ORs of 12.13 (95% CI 8.30–17.74), 5.12 (95% CI 1.19–21.92), and 3.84 (95% CI 2.52–5.86), respectively. Pregnancies complicated with placenta previa, gestational diabetes mellitus (GDM), and premature labor were associated with significantly increased risks for peripartum hysterectomy ( P < 0.05). Conclusion Risk factors for peripartum hysterectomy included cesarean delivery, VBAC, repeat cesarean, placenta previa, GDM, and premature labor. VBAC and repeat cesarean had a similar risk.