Charach and Sheiner identified risk factors for peripartum hysterectomy after uterine rupture. A hysterectomy should be performed as a lifesaving operation and when there are no other options. The authors are from Soroka University Medical Center and Ben-Gurion University of the Negrev in Israel.
Patient selection: uterine rupture during delivery
Many patients with uterine rupture have a uterine scar, often as a result of a previous cesarean delivery.
Risk factors for peripartum hysterectomy:
(1) relaparotomy
(2) extended tear involving the uterine cervix
(3) severe hemorrhage
(4) >= 5 deliveries (“grand multiparity”)
The risk of hysterectomy is increased in women without a history of cesarean section or other reason for a surgical scar. A previous operative area may be easier to repair or less disruptive of tissues.
To read more or access our algorithms and calculators, please log in or register.
