Peripartum hysterectomy in Taiwan

ObjectiveTo investigate the incidence and associated risk factors for peripartum hysterectomy in singleton pregnancies.MethodsA 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.ResultsThere 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).ConclusionRisk factors for peripartum hysterectomy included cesarean delivery, VBAC, repeat cesarean, placenta previa, GDM, and premature labor. VBAC and repeat cesarean had a similar risk.