Working paper

Peripartum hysterectomy in Australia: a working paper using the National Hospital Morbidity Database 2003-04 to 2013-14

Publisher
Public health Women's health Pregnancy Australia
Resources
Attachment Size
apo-nid65218.pdf 1.3 MB
Description

This working paper analyses 11 years of national hospitalisation data to derive the estimated rate of peripartum hysterectomy in Australia in recent years and examine the rates of diagnoses for particular conditions contributing to peripartum hysterectomy. This is part of the National Maternity Data Development Project’s work to develop national data standards for maternal morbidity data items.

Summary

Peripartum hysterectomy, or the surgical removal of the uterus after the birth of a baby, can be a life-saving procedure where other measures have failed to stop haemorrhage after giving birth. It is associated with considerable morbidity for mothers and their babies, and brings an end to a woman’s fertility.

Although peripartum hysterectomy is rare (fewer than 300 per year), internationally, incidence appears to be increasing, and literature suggests that this may be linked to increasing maternal age and an increase in the rate of caesarean sections. However, to date, the national rate of peripartum hysterectomy in Australia has not been reported.

This paper forms part of the work of the National Maternity Data Development Project to develop national data standards for prioritised maternal morbidity items, such as peripartum hysterectomy. National hospitalisation data were used to derive the estimated rate of peripartum hysterectomy in Australia in recent years and examine the rates of diagnoses for particular conditions contributing to peripartum hysterectomy.

Using 11 years of data from the National Hospital Morbidity Database (NHMD) for the period 1 July 2003 to 30 June 2014, 2,781 records were extracted for episodes of care for women undergoing hysterectomy procedures that had a principal diagnosis of an obstetric code or a code indicating hospitalisation for circumstances related to reproduction (‘pregnancy-associated hysterectomy’). Approximately 90% of these hysterectomies were estimated to have occurred in the peripartum period, while about 10% occurred in early pregnancy (before 20 weeks’ gestation). Between 2003–04 and 2013–14, there were 16 deaths (0.6%) recorded among women undergoing peripartum hysterectomy, and 93 fetal deaths (3.7%).

The overall numbers of peripartum hysterectomies increased by 37% between 2003–04 and 2013–14; however, the rate remained relatively stable over this period (about 0.79 per 1,000 mothers giving birth). Older mothers, mothers who were Indigenous, and mothers with multiple births (for example, twins) were over-represented in women who had peripartum hysterectomy, compared with the total maternal population.

Publication Details
ISBN:
978-1-74249-945-1
Access Rights Type:
open