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.


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