Peripartum hysterectomy: A 9-year population-based study in Slovakia

Area of Science:

• Obstetrics and Gynecology
• Reproductive Health
• Public Health

Background:

• Peripartum hysterectomy (PH) is a critical obstetric procedure with significant maternal morbidity and mortality.
• Understanding the incidence and indications of PH is crucial for improving maternal healthcare outcomes.
• Slovakia's specific data on PH incidence and associated factors were previously underexplored.

Purpose of the Study:

• To determine the incidence of peripartum hysterectomy (PH) in Slovakia.
• To identify the primary reasons for PH, including clinical circumstances.
• To document complications and mortality associated with PH.

Main Methods:

• A descriptive, population-based study design was employed.
• Data were collected retrospectively from standardized questionnaires for all PH cases in Slovakia from 2012 to 2020.
• The study compared PH cases against the total number of births during the same period.

Main Results:

• The incidence of peripartum hysterectomy (PH) was 0.91 per 1000 births.
• Placental pathologies (52.9%) and uterine atony (33.0%) were the leading indications for PH.
• Advanced maternal age, multiparity, multiple pregnancies, and cesarean deliveries were associated with higher PH rates. 37.8% of women required intensive care, and the mortality rate was 1.5%.

Conclusions:

• The incidence of peripartum hysterectomy (PH) in Slovakia is notably high compared to other European nations.
• There is a clear need for enhanced prenatal diagnosis of morbidly adherent placenta.
• Improved management strategies for peripartum hemorrhage are essential to reduce PH rates.