Risk Factors for Cesarean Hysterectomy at Maharat Nakhon Ratchasima Hospital

Abstract

Objectives: To evaluate incidence, risk factors and complications of cesarean hysterectomy. Materials and Methods: This was a retrospective case-control study. The study cases included 80 pregnant women with cesarean hysterectomy at Maharat Nakhon Ratchasima Hospital from January 1st, 2010 to December 31st, 2015. The controls referred to 320 pregnant women who underwent cesarean section at the closest time before and after the study cases. The medical records were collected and analysed. Multivariate logistic regression analysis was performed to identify risk factors. Results: During the study period, there were 50,729 deliveries and 80 pregnant women with cesarean hysterectomy (1.58:1,000). The statistically significant risk factors for cesarean hysterectomy were placenta adherent (adjusted odds ratios (AOR) 120.91, 95% confidence interval (95% CI) 22.05-1653.22), uterine atony (AOR 26.77, 95% CI 5.64-127.07), placenta previa (AOR 19.15, 95% CI 5.74-63.92), the tearing of lower uterine segment (AOR 14.92, 95% CI 4.92-45.29), multigravida (AOR 4.84, 95% CI 1.65-14.20) and emergency cesarean section (AOR 3.98, 95% CI 1.26-12.58). Hypovolemia, disseminated intravascular coagulation, postoperative fever and bladder injury were significant common complications. Conclusion: Placenta adherent, uterine atony, placenta previa, the tearing of lower uterine segment, multigravida and emergency cesarean section were identified as significant risk factors for cesarean hysterectomy.