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Original Article
Emergency peripartum hysterectomy in a tertiary teaching hospital in Northern Jordan: a 15-year review
Hasan Rawashdeh
Jordan University of Science and Technology Faculty of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7534-7741
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Gynecological Surgery.
Background
Emergency Peripartum hysterectomy is a major operation performed when conservative measures fail to stop life-threatening postpartum haemorrhage. It is associated with a high rate of maternal morbidity among survivors. The aim of this work is to evaluate the incidence, indication, and complications of peripartum hysterectomy at King Abdulla University Hospital over a 15-year period.
Methods
A retrospective cohort study of emergency peripartum hysterectomy. The incidence was calculated. Risk factors for abnormal placentation were explored. A comparison between total and subtotal hysterectomy in terms of morbidity outcomes was conducted. The Chi-square test, Fisher’s exact and Independent Sample T-Test were used for analysis. Statistical significance was declared at α < 0.05.
Results
The incidence of peripartum hysterectomy was 1.46 per 1000 births. Sixty-three were performed after caesarean section and three were performed after vaginal delivery (P < 0.001). Abnormal placentation (accreta, increta and percreta) was the main indication (46.03%). The strongest risk factor for abnormal placentation was placenta previa with previous caesarean section (P < 0.001, OR 17.33, 95% CI 2.09–143.14). One maternal and three neonatal deaths were recorded. Urinary bladder injury was the most frequent complication (26.98%). No difference in morbidity noted between total and subtotal hysterectomy.
Conclusions
The incidence of emergency peripartum hysterectomy in increasing steadily over the last two decades in the north of Jordan. Abnormal placentation is the commonest indication for emergency peripartum hysterectomy. There is no significant difference between total and subtotal hysterectomy in terms of complications` development, admission to the ICU, and estimated blood loss. The morbidity associated with emergency peripartum hysterectomy is significant.
Keywords
Peripartum, Hysterectomy, Jordan, Review
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CURRENT STATUS: Published
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Published
On 18 Feb, 2021
No community comments so far
Editorial decision: Minor revision
On 07 Nov, 2020
Review #2 received
Received 05 Nov, 2020
Review #1 received
Received 05 Nov, 2020
Reviewer #1 agreed
On 18 Oct, 2020
Reviewer #2 agreed
On 18 Oct, 2020
Editor assigned
On 13 Oct, 2020
Reviewers invited
Invitations sent on 13 Oct, 2020
Submission checks complete
On 12 Oct, 2020
Editor invited
On 12 Oct, 2020
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On 09 Oct, 2020
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This preprint is under consideration at Gynecological Surgery. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Original Article
Emergency peripartum hysterectomy in a tertiary teaching hospital in Northern Jordan: a 15-year review
Hasan Rawashdeh
Jordan University of Science and Technology Faculty of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7534-7741
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 1
Posted 19 Oct, 2020
Published
On 18 Feb, 2021
No community comments so far
Editorial decision: Minor revision
On 07 Nov, 2020
Review #2 received
Received 05 Nov, 2020
Review #1 received
Received 05 Nov, 2020
Reviewer #1 agreed
On 18 Oct, 2020
Reviewer #2 agreed
On 18 Oct, 2020
Editor assigned
On 13 Oct, 2020
Reviewers invited
Invitations sent on 13 Oct, 2020
Submission checks complete
On 12 Oct, 2020
Editor invited
On 12 Oct, 2020
First submitted
On 09 Oct, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Gynecological Surgery.
Background
Emergency Peripartum hysterectomy is a major operation performed when conservative measures fail to stop life-threatening postpartum haemorrhage. It is associated with a high rate of maternal morbidity among survivors. The aim of this work is to evaluate the incidence, indication, and complications of peripartum hysterectomy at King Abdulla University Hospital over a 15-year period.
Methods
A retrospective cohort study of emergency peripartum hysterectomy. The incidence was calculated. Risk factors for abnormal placentation were explored. A comparison between total and subtotal hysterectomy in terms of morbidity outcomes was conducted. The Chi-square test, Fisher’s exact and Independent Sample T-Test were used for analysis. Statistical significance was declared at α < 0.05.
Results
The incidence of peripartum hysterectomy was 1.46 per 1000 births. Sixty-three were performed after caesarean section and three were performed after vaginal delivery (P < 0.001). Abnormal placentation (accreta, increta and percreta) was the main indication (46.03%). The strongest risk factor for abnormal placentation was placenta previa with previous caesarean section (P < 0.001, OR 17.33, 95% CI 2.09–143.14). One maternal and three neonatal deaths were recorded. Urinary bladder injury was the most frequent complication (26.98%). No difference in morbidity noted between total and subtotal hysterectomy.
Conclusions
The incidence of emergency peripartum hysterectomy in increasing steadily over the last two decades in the north of Jordan. Abnormal placentation is the commonest indication for emergency peripartum hysterectomy. There is no significant difference between total and subtotal hysterectomy in terms of complications` development, admission to the ICU, and estimated blood loss. The morbidity associated with emergency peripartum hysterectomy is significant.