Peripartum hysterectomy in Taiwan

Abstract 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  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.