Peripartum hysterectomy between 2009 and 2010 in Sichuan, China

OBJECTIVE: To investigate the incidence and risk factors for peripartum hysterectomy (PH) in Sichuan, China. METHODS: A population-based study was conducted using the obstetric inpatient records of women who gave birth at 1 of 8 hospitals between January 1, 2009, and December 31, 2010. Multivariate logistic regression analysis was used to identify independent risk factors for PH. RESULTS: During the study period, 64 cases of PH occurred among 34014 deliveries (0.2%); abnormal placentation and uterine atony were the major indications for surgery. Several factors significantly increased the risk of PH among the study population: placenta previa (adjusted odds ratio [AOR] 10.0; 95% confidence interval [CI], 5.7-17.7), uterine atony (AOR 7.4; 95% CI, 4.3-12.8), repeat cesarean delivery (AOR 3.0; 95% CI, 1.2-7.7), low birth weight (AOR 2.6; 95% CI, 1.5-4.6), and multiparity (AOR 2.4; 95% CI, 1.3-4.4). By contrast, multiple gestation, primary cesarean delivery, placental abruption, leiomyoma, pre-eclampsia, eclampsia, and diabetes mellitus did not significantly increase the risk of PH. CONCLUSION: Placenta previa, uterine atony, repeat cesarean delivery, low birth weight, and multiparity were risk factors for PH among the study population.