RESULTS
There were 34020 deliveries during the study period. A total of 66 peripartum hysterectomies were performed with an incidence of 1.9 per 1000 deliveries. We analyzed 66 patients who underwent peripartum hysterectomy. Mean age of patients was 31.3±5.5 years. The gravidity ranged between 1 and 12 with a mean of 3.9±2.4. The average gestational age was 35.7±3.7 weeks. Of these 66, 14(21.2%) women delivered vaginally and 52(78.8%) women had cesarean section. Half of the patients(n=33) had at least one previous cesarean section. The most common indications for overall study population was placenta accreata(n=26, 39.4%) and the second one was uterine atony(n=20, 30.3%). Twenty-four(36.4%) patients had subtotal abdominal hsyterectomy and in 42 patients(63.6%), total abdominal hysterectomy was performed. We scheduled planned hysterectomy in 31(47%) patients, while emergent hysterectomy was performed in 35(53%) cases. Table 1 summarizes the demographic and clinical parameters of emergent and planned surgery groups. The mean gestational age was significantly lower in the planned hysterectomy group(p=0.002). Moreover, more than 90% of the patients in the planned group delivered after 34 gestational weeks. We showed the indications of hysterectomy for study groups(Table 2). The uterine atony was the most common indication in the emergent group, whereas abnormal placentation was the most common indication in the planned group(57.1% and 67.7% , respectively). We compared the blood transfusions, postoperative laboratory values and intraoperative complications between the emergent and planned hysterectomy groups(Table 3). The planned hysterectomy group was required significantly lower blood products in the intra- and post-operative period. The postoperative Hb and the differences of pre- and post-operative Hb values were also significantly different among study groups. The complication rates were similar for emergent and planned surgery groups. The duration of hospital stay was lower in the planned surgery but it did not reach any statistical significance. Table 4 presented that the neonatal outcomes were significantly different between emergent and planned hysterectomy groups. The mean birth weight was significantly lower in the planned group, it might be related to the lower gestational weeks on the surgery time. Although we have demonstrated the lower birth weight in the planned group, the apgar scores were significantly better than the emergent hysterectomy group(p<0.01).