摘要
OBJECTIVE: To compare the occurrence of peripartum hysterectomy between sing le ton and multiple gestations. METHODS: This was a historical cohort study compari ng the occurrence of peripartum hysterectomy between singleton and multiple gest a tions at Banner Good Samaritan Regional Medical Center, Phoenix, Arizona, from J anuary 1, 1996, to December 31, 2001. RESULTS: During the study years, 42,595 si ngleton, 1,131 twin, 164 triplet, 35 quadruplet, and 2 quintuplet deliveries occ urred. A total of 100 peripartum hysterectomies were performed. Of these hystere ctomies, 88 occurred in singletons, 5 in twins, 6 in triplets, and 1 in quadrupl ets. The overall occurrence of peripartum hysterectomy was 2.28 per 1000, and th e occurrence of emergent peripartum hysterectomy was 1.73 per 1000. Multiple ges tations had a significantly greater risk of emergent peripartum hysterectomy tha n singletons (odds ratio [OR] 6.04, 95%confidence interval [CI] 3.28-11.11; P < .001). This difference was more pronounced among higher-order multiple gestat ions: twins (OR 2.95, 95%CI 1.22-7.13, P = .03), triplets (OR 25.22, 95%CI 11 .02-57.77, P < .001), and quadruplets (OR 19.53, 95%CI 3.34-114.69, P = .04). When compared with singletons, higher-order multiple gestations had nearly a 2 4-fold increased risk of emergent peripartum hysterectomy (OR 23.97, 95%CI 11. 05-51.99, P < .001). CONCLUSION: Multiple gestations have a significantly highe r occurrence of emergent peripartum hysterectomy than singletons. This informati on should be used in counseling and managing patients with these pregnancies.
OBJECTIVE: To compare the occurrence of peripartum hysterectomy between sing le ton and multiple gestations. METHODS: This was a historical cohort study compari ng the occurrence of peripartum hysterectomy between singleton and multiple gest a tions at Banner Good Samaritan Regional Medical Center, Phoenix, Arizona, from J anuary 1, 1996, to December 31, 2001. RESULTS: During the study years, 42,595 si ngleton, 1,131 twin, 164 triplet, 35 quadruplet, and 2 quintuplet deliveries occ urred. A total of 100 peripartum hysterectomies were performed. Of these hystere ctomies, 88 occurred in singletons, 5 in twins, 6 in triplets, and 1 in quadrupl ets. The overall occurrence of peripartum hysterectomy was 2.28 per 1000, and th e occurrence of emergent peripartum hysterectomy was 1.73 per 1000. Multiple ges tations had a significantly greater risk of emergent peripartum hysterectomy tha n singletons (odds ratio [OR] 6.04, 95%confidence interval [CI] 3.28-11.11; P < .001). This difference was more pronounced among higher-order multiple gestat ions: twins (OR 2.95, 95%CI 1.22-7.13, P = .03), triplets (OR 25.22, 95%CI 11 .02-57.77, P < .001), and quadruplets (OR 19.53, 95%CI 3.34-114.69, P = .04). When compared with singletons, higher-order multiple gestations had nearly a 2 4-fold increased risk of emergent peripartum hysterectomy (OR 23.97, 95%CI 11. 05-51.99, P < .001). CONCLUSION: Multiple gestations have a significantly highe r occurrence of emergent peripartum hysterectomy than singletons. This informati on should be used in counseling and managing patients with these pregnancies.
