Background: Severe postpartum hemorrhage (PPH) is a potentially life-threatening situation that sometimes requires a hysterectomy. We examined the national incidence, risk factors, indications, outcomes and complications of peripartum hysterectomy following vaginal and caesarean delivery.
Methods: Peripartum hysterectomy was defined as a hysterectomy after birth until 1 month after delivery using the codes for hysterectomy from the NOMESCO classification (1995). National data from the period 1995-2004 were extracted from the Danish Medical Birth Register and linked to the Danish National Hospital Register followed by registration of relevant data from the medical records of all the patients.
Results: We found 152 hysterectomies corresponding to an incidence of 0.24/1,000 deliveries. The risk of peripartum hysterectomy increased 11-fold following caesarean compared to vaginal delivery. Placenta accrete was present in 37% of the cases and 68%.
Conclusion: Peripartum hysterectomy has increased significantly during the last 20 years. Optimizing treatment of PPH may decrease the incidence of peripartum hysterectomy in the future.
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Article Synopsis
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- - This study identified miR-23a-5p as a potentially valuable biomarker for PAS through RNA-seq and qRT-PCR analysis, showing it is down-regulated in PAS cases while its target genes ASF1B and CHTF8 are up-regulated.
- - Combining miR-23a-5p with CHTF8 enhances diagnostic accuracy for PAS and related adverse outcomes, with improved AUC values suggesting their effectiveness as novel biomarkers.
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