Objective: The aim of the research was to investigate incidence, riskfactors, and complications associated with emergency peripartumhysterectomy (EPH), the ultimate treatment method for intractablepostpartum hemorrhage (PPH). Methods: This is a single center case-control study conducted inChongqing city in central China from 1st January 2007-31st December 2012for EPH performed as a treatment of postpartum hemorrhage (PPH) both incaesarean and vaginal delivery cases.While the study group included EPH(n=61) due to intractable PPH, the control group included no hysterectomy(n=333) during the same study period. Results: We found 61 cases recorded for EPH for intractable PPH.Incidence of peripartum hysterectomy was 2.2 per 1000 deliveries.EPH astreatment of intractable PPH include the followings: (i) blood loss 1000-2000 ml, crude odd ratio (OR) =18.48 (95％ CI 5.1-65.7), adjusted oddratio (AOR) =9.1 (95％ CI 2.2-37.7); (ii) blood loss ＞ 2000 ml, OR =152(95％ CI 43.7-528.4), AOR =45.3 (95％CI 11.6-176.9); (iii) previouscaesarean section, OR =5.5 (95％ CI 2.9-9.7), AOR =3.7(95％ CI 1.4-9.9);(iv) uterine atony, OR =11.9 (95％ CI 5.8-24.6), AOR =7.5 (95％ CI 1.8-30.2); (v) placenta previa, OR =2.04 (95％ CI 1.1-3.5), AOR =none. Conclusions: EPH is the last resort as treatment of intractable severepostpartum hemorrhage.Our study depicts that severe post partumhemorrhage, further dreaded complex events for EPH, has significantassociation with placental factors, previous caesarean section, and uterineatony.Pathologically, placenta accreta remained the most leading cause ofhysterectomy.
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