Department of Obstetrics and Gynecology, Temple University Hospital, Philadelphia, PA, USA.
Arch Gynecol Obstet. 2011 Jun;283(6):1261-8. doi: 10.1007/s00404-010-1554-6. Epub 2010 Jun 17.
To provide an estimate of the incidence of peripartum hysterectomy in the state of New Jersey and calculate the effect of mode of delivery and prior obstetric history.
A perinatal-linked dataset provided by the Maternal Child Health Epidemiology Program in the New Jersey Department of Health was used to obtain information from birth certificates and hospital discharge records. Using multivariate logistic regression, various demographic and clinical factors were assessed for association with peripartum hysterectomy.
A total of 1,004,116 births were identified between 1997 and 2005 and 853 peripartum hysterectomies were performed (0.85/1,000 deliveries). Parity increased the risk of hysterectomy with nulliparous women having approximately half the risk compared to multiparous women. Cesarean delivery with no previous c-section almost doubled the risk (OR 2.20, CI 1.80-26.69) while in the presence of a previous c-section the risk was almost four times higher (OR 4.51, CI 3.76-5.40). Operative vaginal delivery did not result in any increase in the risk.
Mode of delivery and prior obstetric history are major risk factors for peripartum hysterectomy. Patients desiring cesarean delivery need to be counseled on the risk of this serious complication.
估计新泽西州围产期子宫切除术的发病率，并计算分娩方式和既往产科史的影响。
使用新泽西州卫生署母婴健康流行病学计划提供的围产期相关数据集，从出生证明和医院出院记录中获取信息。采用多变量逻辑回归，评估各种人口统计学和临床因素与围产期子宫切除术的相关性。
在 1997 年至 2005 年间共确定了 1,004,116 例分娩，其中 853 例（0.85/1,000 分娩）行围产期子宫切除术。产次增加了子宫切除术的风险，初产妇的风险比多产妇低一半左右。无既往剖宫产的剖宫产几乎使风险增加了一倍（OR 2.20，CI 1.80-26.69），而有既往剖宫产史的风险几乎增加了四倍（OR 4.51，CI 3.76-5.40）。阴道助产分娩并未增加风险。
分娩方式和既往产科史是围产期子宫切除术的主要危险因素。需要对选择剖宫产的患者进行风险咨询。
Zotero 插件