Epidemiological analysis of peripartum hysterectomy across nine European countries
- Author
- Athanasios F. Kallianidis, Alice Maraschini, Jakub Danis, Lotte B. Colmorn, Catherine Deneux-Tharaux, Serena Donati, Mika Gissler, Maija Jakobsson, Marian Knight, Alexandra Kristufkova, Pelle G. Lindqvist, Griet Vandenberghe (UGent) and Thomas Van Den Akker
- Organization
- Abstract
- Introduction Peripartum hysterectomy is a surgical procedure performed for severe obstetric complications such as major obstetric hemorrhage. The prevalence of peripartum hysterectomy in high-resource settings is relatively low. Hence, international comparisons and studying indications and associations with mode of birth rely on the use of national obstetric survey data. Objectives were to calculate the prevalence and indications of peripartum hysterectomy and its association with national cesarean section rates and mode of birth in nine European countries. Material and methods We performed a descriptive, multinational, population-based study among women who underwent peripartum hysterectomy. Data were collected from national or multiregional databases from nine countries participating in the International Network of Obstetric Survey Systems. We included hysterectomies performed from 22 gestational weeks up to 48 hours postpartum for obstetric hemorrhage, as this was the most restrictive, overlapping case definition between all countries. Main outcomes were prevalence and indications of peripartum hysterectomy. Additionally, we compared prevalence of peripartum hysterectomy between women giving birth vaginally and by cesarean section, and between women giving birth with and without previous cesarean section. Finally, we calculated correlation between prevalence of peripartum hysterectomy and national cesarean section rates, as well as national rates of women giving birth after a previous cesarean section. Results A total of 1302 peripartum hysterectomies were performed in 2 498 013 births, leading to a prevalence of 5.2 per 10 000 births ranging from 2.6 in Denmark to 10.7 in Italy. Main indications were uterine atony (35.3%) and abnormally invasive placenta (34.8%). Relative risk of hysterectomy after cesarean section compared with vaginal birth was 9.1 (95% CI 8.0-10.4). Relative risk for hysterectomy for birth after previous cesarean section compared with birth without previous cesarean section was 10.6 (95% CI 9.4-12.1). A strong correlation was observed between national cesarean section rate and prevalence of peripartum hysterectomy (rho = 0.67, P < .05). Conclusions Prevalence of peripartum hysterectomy may vary considerably between high-income countries. Uterine atony and abnormally invasive placenta are the commonest indications for hysterectomy. Birth by cesarean section and birth after previous cesarean section are associated with nine-fold increased risk of peripartum hysterectomy.
- Keywords
- OBSTETRIC SURVEILLANCE SYSTEM, MATERNAL MORBIDITY, PREGNANCY, DELIVERY, OUTCOMES, RISK, UK, cesarean section, maternal morbidity, mode of birth, obstetric, hemorrhage, peripartum hysterectomy
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Please use this url to cite or link to this publication: http://hdl.handle.net/1854/LU-8701566
- MLA
- Kallianidis, Athanasios F., et al. “Epidemiological Analysis of Peripartum Hysterectomy across Nine European Countries.” ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, vol. 99, no. 10, 2020, pp. 1364–73, doi:10.1111/aogs.13892.
- APA
- Kallianidis, A. F., Maraschini, A., Danis, J., Colmorn, L. B., Deneux-Tharaux, C., Donati, S., … Van Den Akker, T. (2020). Epidemiological analysis of peripartum hysterectomy across nine European countries. ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, 99(10), 1364–1373. https://doi.org/10.1111/aogs.13892
- Chicago author-date
- Kallianidis, Athanasios F., Alice Maraschini, Jakub Danis, Lotte B. Colmorn, Catherine Deneux-Tharaux, Serena Donati, Mika Gissler, et al. 2020. “Epidemiological Analysis of Peripartum Hysterectomy across Nine European Countries.” ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA 99 (10): 1364–73. https://doi.org/10.1111/aogs.13892.
- Chicago author-date (all authors)
- Kallianidis, Athanasios F., Alice Maraschini, Jakub Danis, Lotte B. Colmorn, Catherine Deneux-Tharaux, Serena Donati, Mika Gissler, Maija Jakobsson, Marian Knight, Alexandra Kristufkova, Pelle G. Lindqvist, Griet Vandenberghe, and Thomas Van Den Akker. 2020. “Epidemiological Analysis of Peripartum Hysterectomy across Nine European Countries.” ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA 99 (10): 1364–1373. doi:10.1111/aogs.13892.
- Vancouver
- 1.Kallianidis AF, Maraschini A, Danis J, Colmorn LB, Deneux-Tharaux C, Donati S, et al. Epidemiological analysis of peripartum hysterectomy across nine European countries. ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA. 2020;99(10):1364–73.
- IEEE
- [1]A. F. Kallianidis et al., “Epidemiological analysis of peripartum hysterectomy across nine European countries,” ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, vol. 99, no. 10, pp. 1364–1373, 2020.
@article{8701566, abstract = {{Introduction Peripartum hysterectomy is a surgical procedure performed for severe obstetric complications such as major obstetric hemorrhage. The prevalence of peripartum hysterectomy in high-resource settings is relatively low. Hence, international comparisons and studying indications and associations with mode of birth rely on the use of national obstetric survey data. Objectives were to calculate the prevalence and indications of peripartum hysterectomy and its association with national cesarean section rates and mode of birth in nine European countries. Material and methods We performed a descriptive, multinational, population-based study among women who underwent peripartum hysterectomy. Data were collected from national or multiregional databases from nine countries participating in the International Network of Obstetric Survey Systems. We included hysterectomies performed from 22 gestational weeks up to 48 hours postpartum for obstetric hemorrhage, as this was the most restrictive, overlapping case definition between all countries. Main outcomes were prevalence and indications of peripartum hysterectomy. Additionally, we compared prevalence of peripartum hysterectomy between women giving birth vaginally and by cesarean section, and between women giving birth with and without previous cesarean section. Finally, we calculated correlation between prevalence of peripartum hysterectomy and national cesarean section rates, as well as national rates of women giving birth after a previous cesarean section. Results A total of 1302 peripartum hysterectomies were performed in 2 498 013 births, leading to a prevalence of 5.2 per 10 000 births ranging from 2.6 in Denmark to 10.7 in Italy. Main indications were uterine atony (35.3%) and abnormally invasive placenta (34.8%). Relative risk of hysterectomy after cesarean section compared with vaginal birth was 9.1 (95% CI 8.0-10.4). Relative risk for hysterectomy for birth after previous cesarean section compared with birth without previous cesarean section was 10.6 (95% CI 9.4-12.1). A strong correlation was observed between national cesarean section rate and prevalence of peripartum hysterectomy (rho = 0.67, P < .05). Conclusions Prevalence of peripartum hysterectomy may vary considerably between high-income countries. Uterine atony and abnormally invasive placenta are the commonest indications for hysterectomy. Birth by cesarean section and birth after previous cesarean section are associated with nine-fold increased risk of peripartum hysterectomy.}}, author = {{Kallianidis, Athanasios F. and Maraschini, Alice and Danis, Jakub and Colmorn, Lotte B. and Deneux-Tharaux, Catherine and Donati, Serena and Gissler, Mika and Jakobsson, Maija and Knight, Marian and Kristufkova, Alexandra and Lindqvist, Pelle G. and Vandenberghe, Griet and Van Den Akker, Thomas}}, issn = {{0001-6349}}, journal = {{ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA}}, keywords = {{OBSTETRIC SURVEILLANCE SYSTEM,MATERNAL MORBIDITY,PREGNANCY,DELIVERY,OUTCOMES,RISK,UK,cesarean section,maternal morbidity,mode of birth,obstetric,hemorrhage,peripartum hysterectomy}}, language = {{eng}}, number = {{10}}, pages = {{1364--1373}}, title = {{Epidemiological analysis of peripartum hysterectomy across nine European countries}}, url = {{http://doi.org/10.1111/aogs.13892}}, volume = {{99}}, year = {{2020}}, }
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