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Is peripartum hysterectomy more common in multiple gestations?
Karrie Francois1, Joseph Ortiz, Cathleen Harris
1Phoenix Perinatal Associates and Banner Good Samaritan Regional Medical Center, Scottsdale, Arizona 85255, USA. karrie_francois@obstetrix.com
Obstetrics and Gynecology
|June 4, 2005
Summary
Multiple gestations significantly increase the risk of emergent peripartum hysterectomy compared to singleton pregnancies. Healthcare providers should consider this heightened risk during patient counseling and management.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Surgical Outcomes
Background:
- Peripartum hysterectomy is a critical obstetric procedure with potential maternal morbidity.
- Multiple gestations are associated with various obstetric complications, but their specific risk for peripartum hysterectomy requires detailed analysis.
Purpose of the Study:
- To investigate and compare the incidence of peripartum hysterectomy in singleton versus multiple gestations.
- To determine the specific risks associated with higher-order multiple gestations.
Main Methods:
- A historical cohort study was conducted at a regional medical center.
- Data were collected from January 1, 1996, to December 31, 2001.
- Occurrence of peripartum hysterectomy was compared between singleton and multiple gestations.
Main Results:
- Multiple gestations demonstrated a significantly higher risk of emergent peripartum hysterectomy (OR 6.04).
- The risk escalated with higher-order multiples: twins (OR 2.95), triplets (OR 25.22), and quadruplets (OR 19.53).
- Higher-order multiple gestations faced a nearly 24-fold increased risk compared to singletons (OR 23.97).
Conclusions:
- Multiple gestations carry a substantially elevated risk of emergent peripartum hysterectomy.
- Findings underscore the importance of this information for counseling and managing pregnancies with multiples.
