ArticleBMJ open2017
A nationwide population-based cohort study of peripartum hysterectomy and arterial embolisation in Belgium: results from the Belgian Obstetric Surveillance System.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 16 citations in OpenAlex.
- Article
- Interventional radiology for prevention and management of postpartum haemorrhage: a single centre retrospective cohort study.Archives of gynecology and obstetrics · 2025Article
- Uterine Factor Infertility, a Systematic Review.Journal of clinical medicine · 2022Review
- Peripartum hysterectomy due to severe postpartum hemorrhage: A hospital-based study.Acta obstetricia et gynecologica Scandinavica · 2022Article
- Management of major obstetric hemorrhage prior to peripartum hysterectomy and outcomes across nine European countries.Acta obstetricia et gynecologica Scandinavica · 2021Article
- Epidemiological analysis of peripartum hysterectomy across nine European countries.Acta obstetricia et gynecologica Scandinavica · 2020Article
- The Belgian Obstetric Surveillance System to monitor severe maternal morbidity.Facts, views & vision in ObGyn · 2017Article
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Authors and funding
10 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess the prevalence of major obstetric haemorrhage managed with peripartum hysterectomy and/or interventional radiology (IR) in Belgium. To describe women characteristics, the circumstances in which the interventions took place, the management of the obstetric haemorrhage, the outcome and additional morbidity of these women.
designNationwide population-based prospective cohort study.
settingEmergency obstetric care. Participation of 97% of maternities covering 98.6% of deliveries in Belgium.
participantsAll women who underwent peripartum hysterectomy and/or IR procedures in Belgium between January 2012 and December 2013.
resultsWe obtained data on 166 women who underwent peripartum hysterectomy (n=84) and/or IR procedures (n=102), corresponding to 1 in 3030 women undergoing a peripartum hysterectomy and another 1 in 3030 women being managed by IR, thereby preserving the uterus. Seventeen women underwent hysterectomy following IR and three women needed further IR despite hysterectomy. Abnormal placentation and/or uterine atony were the reported causes of haemorrhage in 83.7%. Abnormally invasive placenta was not detected antenatally in 34% of cases. The interventions were planned in 15 women. Three women were transferred antenatally and 17 women postnatally to a hospital with emergency IR service. Urgent peripartum hysterectomy was averted in 72% of the women who were transferred, with no significant difference in need for transfusion. IR procedures were able to stop the bleeding in 87.8% of the attempts. Disseminated intravascular coagulation secondary to major haemorrhage was reported in 32 women (19%).
conclusionThe prevalence in Belgium of major obstetric haemorrhage requiring peripartum hysterectomy and/or IR is estimated at 6.6 (95% CI 5.7 to 7.7) per 10 000 deliveries. Increased clinician awareness of the risk factors of abnormal placentation could further improve the management and outcome of major obstetric haemorrhage. A case-by-case in-depth analysis is necessary to reveal whether the hysterectomies and arterial embolisations performed in this study were appropriate or preventable.
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