Department of Medicine and Public Health, University of Bologna, Bologna, Italy.
Acta Obstet Gynecol Scand. 2010 Mar;89(3):321-7. doi: 10.3109/00016340903508627.
To estimate the incidence of peripartum hysterectomy in an Italian Region (Emilia-Romagna) and investigate its association with cesarean delivery.
Population-based retrospective study using hospital discharge records.
All public and private hospitals in Emilia-Romagna region, Italy.
A total of 151,494 women delivering between 2003 and 2006, 131 of whom had a peripartum hysterectomy.
Peripartum hysterectomy was defined as a hysterectomy performed at the time of delivery or afterwards during the same hospitalization. Incidence rates were calculated by type of delivery. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated with logistic regression to evaluate the association between peripartum hysterectomy and delivery type.
Incidence rates of peripartum hysterectomy by type of delivery; odds of peripartum hysterectomy after primary or repeat cesarean compared with vaginal delivery without previous cesarean.
A total of 131 peripartum hysterectomies were performed among 151,494 deliveries (0.86/1,000 deliveries; 95% CI 0.72-1.03) with 20.7% primary and 9.6% repeat cesarean deliveries. Women undergoing a primary caesarean delivery were more likely to have a peripartum hysterectomy than women having a vaginal delivery who had never had a cesarean delivery (OR 6.48; 95% CI 4.16-10.07). Women undergoing a repeat caesarean delivery were also at increased risk (OR 3.69; 95% CI 2.11-6.46).
In this population, primary and repeat cesarean deliveries are associated with an increased risk of peripartum hysterectomy. These results are of particular concern given the steady increase in the cesarean delivery rate in many countries. The pathological mechanism of this association requires further investigation.
评估意大利艾米利亚-罗马涅（Emilia-Romagna）地区的围产期子宫切除术发病率，并研究其与剖宫产术的关联。
基于人群的回顾性研究，利用医院出院记录。
意大利艾米利亚-罗马涅地区的所有公立和私立医院。
2003 年至 2006 年期间分娩的 151494 名妇女，其中 131 人接受了围产期子宫切除术。
围产期子宫切除术定义为分娩时或同一住院期间进行的子宫切除术。按分娩类型计算发病率。使用逻辑回归估计比值比（ORs）及其 95%置信区间（CIs），以评估围产期子宫切除术与分娩类型之间的关联。
按分娩类型计算的围产期子宫切除术发病率；与无先前剖宫产的阴道分娩相比，初次或再次剖宫产后围产期子宫切除术的可能性。
在 151494 例分娩中，共进行了 131 例围产期子宫切除术（0.86/1000 例分娩；95%CI 0.72-1.03），其中 20.7%为初次剖宫产，9.6%为再次剖宫产。初次剖宫产的女性比从未行剖宫产的阴道分娩女性更有可能进行围产期子宫切除术（OR 6.48；95%CI 4.16-10.07）。再次剖宫产的女性也处于较高风险（OR 3.69；95%CI 2.11-6.46）。
在该人群中，初次和再次剖宫产与围产期子宫切除术风险增加相关。鉴于许多国家剖宫产率的稳步上升，这些结果尤其令人关注。这种关联的病理机制需要进一步研究。
