Maternal characteristics, clinical indications, and neonatal outcomes in cesarean hysterectomy: A cross‑sectional study

Background: Cesarean hysterectomy (CH) is a life-saving surgical procedure performed in obstetric emergencies, particularly in cases of uncontrollable hemorrhage, placenta previa, and abnormal placental adherence. Objective: This study aimed to evaluate the maternal characteristics, associated clinical factors, complications, and neonatal outcomes observed in CH. Materials and Methods: In this cross-sectional study, data of ۸۹ women who underwent CH at Sayad Shirazi hospital, Gorgan, Iran, between ۲۰۱۳ and ۲۰۲۲ were extracted from participants’ medical records using a structured checklist covering maternal demographics, comorbidities, placental conditions, surgical outcomes, and neonatal results. Results: The mean maternal age was ۳۴.۶۵ ± ۵.۲ yr, body mass index ۲۸.۷۸ ± ۳.۴ kg/m², and gestational age ۳۴.۵۴ ± ۳.۲ wk. Placenta previa was present in ۸۸.۶% of cases, with placenta increta (۴۶.۱%), accreta (۲۹.۲%), and percreta (۲۱.۳%) being the most common placenta accreta spectrum subtypes. Preoperative and postoperative hemoglobin levels were ۱۱.۲ ± ۱.۸ and ۸.۱۵ ± ۱.۵۶ g/dL, respectively. Blood transfusion was required in ۹۴.۴% of cases. Intensive care unit admission was required in ۹۳.۳%, with a mean stay of ۲.۰۱ ± ۰.۱۱ days. Intraoperative organ injury occurred in ۲۰.۲% of cases. Mean neonatal birth weight was ۲۴۱۴.۶۱ ± ۶۸۲ gr, with ۶۸.۱% requiring neonatal intensive care unit admission primarily due to prematurity. No maternal or neonatal deaths occurred. Conclusion: Placenta previa and placenta accreta spectrum disorders are the primary risk factors for CH. Adequate preparation, including blood product reserves and intensive care unit/neonatal intensive care unit availability, is essential for managing these high-risk cases. As a descriptive study without a comparison group, these findings reflect observed patterns rather than causal associations.

کلیدواژه ها:

Cesarean ، Hysterectomy ، Placenta previa ، Placenta accreta. ، سزارین ، هیسترکتومی ، جفت سرراهی ، جفت آکرتا.