Placental and uterine pathology in women undergoing peripartum hysterectomy

Jennifer S. Hernandez, Nina Nuangchamnong, Mandolin Ziadie, George D. Wendel, Jeanne S. Sheffield

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective: To estimate if peripartum hysterectomies performed for intractable uterine atony have pathologic findings consistent with infection more often than those hysterectomies performed for other indications. Methods: This is a retrospective cohort study of all consecutive peripartum hysterectomies at our institution from 1988 to 2009. Scheduled cesarean hysterectomies were excluded. Maternal, fetal, and pathologic data were obtained by medical record review. Pathologic evaluation was performed for each specimen per a standardized protocol. Patients undergoing hysterectomy for uterine atony were compared with those requiring hysterectomy for another indication. Pearson's χ 2 and Student's t test were used for analysis. Results: Of 324,654 deliveries during the study period, 558 (1.7%) women underwent emergent peripartum hysterectomies; 190 (34%) were for intractable uterine atony. Those requiring hysterectomy for uterine atony were more likely to be at term (87% compared with 62%), have clinical chorioamnionitis (19% compared with 6%), and have longer labors (8 hours compared with 2.5 hours). Certain placental pathologic findings were significantly more common in the atony group, including chorioamnionitis, umbilical vasculitis, chorionic plate vasculitis, and funisitis. Acute endometritis and cervicitis were also more common in the atony group. Conversely, abnormal placental implantation (37% compared with 8%) and leiomyomas (21% compared with 8%) were significantly more common in the group requiring hysterectomy for other indications. Conclusion: Patients requiring emergent peripartum hysterectomies as a result of intractable uterine atony are more likely to have clinical and pathologic findings consistent with acute inflammation and infection.

Original languageEnglish (US)
Pages (from-to)1137-1142
Number of pages6
JournalObstetrics and Gynecology
Volume119
Issue number6
DOIs
StatePublished - Jun 2012

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Peripartum Period
Hysterectomy
Uterine Inertia
Pathology
Chorioamnionitis
Vasculitis
Uterine Cervicitis
Umbilicus
Endometritis
Leiomyoma
Infection
Medical Records
Cohort Studies
Retrospective Studies
Mothers
Students
Inflammation

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Hernandez, J. S., Nuangchamnong, N., Ziadie, M., Wendel, G. D., & Sheffield, J. S. (2012). Placental and uterine pathology in women undergoing peripartum hysterectomy. Obstetrics and Gynecology, 119(6), 1137-1142. https://doi.org/10.1097/AOG.0b013e318253d78a

Placental and uterine pathology in women undergoing peripartum hysterectomy. / Hernandez, Jennifer S.; Nuangchamnong, Nina; Ziadie, Mandolin; Wendel, George D.; Sheffield, Jeanne S.

In: Obstetrics and Gynecology, Vol. 119, No. 6, 06.2012, p. 1137-1142.

Research output: Contribution to journalArticle

Hernandez, JS, Nuangchamnong, N, Ziadie, M, Wendel, GD & Sheffield, JS 2012, 'Placental and uterine pathology in women undergoing peripartum hysterectomy', Obstetrics and Gynecology, vol. 119, no. 6, pp. 1137-1142. https://doi.org/10.1097/AOG.0b013e318253d78a
Hernandez JS, Nuangchamnong N, Ziadie M, Wendel GD, Sheffield JS. Placental and uterine pathology in women undergoing peripartum hysterectomy. Obstetrics and Gynecology. 2012 Jun;119(6):1137-1142. https://doi.org/10.1097/AOG.0b013e318253d78a
Hernandez, Jennifer S. ; Nuangchamnong, Nina ; Ziadie, Mandolin ; Wendel, George D. ; Sheffield, Jeanne S. / Placental and uterine pathology in women undergoing peripartum hysterectomy. In: Obstetrics and Gynecology. 2012 ; Vol. 119, No. 6. pp. 1137-1142.
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