Post-birth hysterectomies increase: study

An increase in the number of emergency hysterectomies among women who have given birth has been linked to the increase in caesarean sections in Australia.

A doctor prepares for surgery

Source: AAP

The number of women who have had potentially life-saving peripartum hysterectomies in Australia has increased.

New research on this rare yet emergency surgery has found the increase is strongly associated with increased rates of caesarean sections in Australia.

A peripartum hysterectomy is the removal of a woman's uterus within the first 24 hours of giving birth and is performed to prevent catastrophic bleeding.

Using 11 years of hospital records from July 2003 to June 2014, the AIHW analysed more than 2500 records of women undergoing a pregnancy-associated hysterectomy.

Approximately 90 per cent of these hysterectomies were estimated to have occurred in the peripartum period, while about 10 per cent occurred in early pregnancy (before 20 weeks' gestation).

Between 2003-04 and 2013-14, there were 16 deaths (0.6 per cent) recorded among women undergoing peripartum hysterectomy, and 93 fetal deaths (3.7 per cent).

The overall numbers of peripartum hysterectomies increased by 37 per cent, although the rate remains the same.

The findings of the analysis are consistent with international studies showing that peripartum hysterectomy is strongly associated with caesarean section delivery.

Over the 11-year period, 0.6 per 1000 women giving birth had a caesarean section and a peripartum hysterectomy in the same hospital admission.

Melbourne obstetrician Professor Jeremy Oats is not surprised by the increase but says it does again raise the debate about the rates of cesarean section births in Australia.

"This is a recognised future complication for women who have cesarean sections. So it's important that this information is out.

"The risks to the individual is small but when you are bringing all these together then we are seeing more of them."

The federal government's 2013 Mothers and Babies report showed the caesarean section rate had increased by five per cent since 2003 and that mothers older than 40 were around three times as likely to deliver by caesarean section compared with teenage mothers.

Dr Oats says awareness about the major risks of having a c-section, especially when its for a second time, is "terribly important".

2 min read
Published 5 July 2016 at 12:18pm
Source: AAP