Rising global incidence of peripartum hysterectomy, how to address this challenge? An invited review by the European Board and College of Obstetrics and Gynaecology (EBCOG)
Donati, Serena ; Troìa, Libera ; Alexander, Sophie ; Ventura, Charles Savona ; Kristufkova, Alexandra ; Velebil, Petr ; Zaigham, Mehreen LU
and Mahmood, Tahir
(2026)
In European Journal of Obstetrics and Gynecology and Reproductive Biology
324.
- Abstract
Peripartum hysterectomy (PH), the surgical removal of the uterus during the peripartum period, is a rare but potentially life-saving intervention for severe obstetric complications such as major haemorrhage, uterine rupture, and placenta accreta spectrum (PAS). As a maternal near-miss event, PH carries substantial maternal and neonatal morbidity, mortality, and long-term psychological impact. Data from the European INOSS network report an incidence of pH of 5.2 per 10,000 births, with notable variation between countries.Uterine atony and PAS are the leading indications, while major risk factors include advanced maternal age, multiparity, and especially prior caesarean section due to its association with abnormal placentation. Management... (More)
Peripartum hysterectomy (PH), the surgical removal of the uterus during the peripartum period, is a rare but potentially life-saving intervention for severe obstetric complications such as major haemorrhage, uterine rupture, and placenta accreta spectrum (PAS). As a maternal near-miss event, PH carries substantial maternal and neonatal morbidity, mortality, and long-term psychological impact. Data from the European INOSS network report an incidence of pH of 5.2 per 10,000 births, with notable variation between countries.Uterine atony and PAS are the leading indications, while major risk factors include advanced maternal age, multiparity, and especially prior caesarean section due to its association with abnormal placentation. Management of severe obstetric haemorrhage follows a multidisciplinary, stepwise process from medical therapy and conservative surgical techniques to hysterectomy when necessary. Differences in clinical definitions, access to interventional radiology, and availability of specialized centres affect comparability and outcomes.Improving maternal outcomes and reducing preventable PH requires strengthened population-based surveillance, standardized definitions and guidelines, multidisciplinary training, and structured psychosocial follow-up.
(Less)
- author
- Donati, Serena
; Troìa, Libera
; Alexander, Sophie
; Ventura, Charles Savona
; Kristufkova, Alexandra
; Velebil, Petr
; Zaigham, Mehreen
LU
and Mahmood, Tahir
- publishing date
- 2026-08
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Massive haemorrhage, Maternalnear-miss, Obstetric complications, Obstetric surveillance, Peripartum hysterectomy, Placentaaccreta spectrum disorders
- in
- European Journal of Obstetrics and Gynecology and Reproductive Biology
- volume
- 324
- article number
- 115232
- publisher
- Elsevier
- external identifiers
-
- pmid:42314489
- scopus:105042106765
- ISSN
- 0301-2115
- DOI
- 10.1016/j.ejogrb.2026.115232
- language
- English
- LU publication?
- no
- additional info
- Publisher Copyright: © 2026 Published by Elsevier B.V.
- id
- f1f3489e-732a-4a75-a678-ad95a5978547
- date added to LUP
- 2026-06-23 15:40:43
- date last changed
- 2026-10-01 16:46:09
@article{f1f3489e-732a-4a75-a678-ad95a5978547,
abstract = {{<p>Peripartum hysterectomy (PH), the surgical removal of the uterus during the peripartum period, is a rare but potentially life-saving intervention for severe obstetric complications such as major haemorrhage, uterine rupture, and placenta accreta spectrum (PAS). As a maternal near-miss event, PH carries substantial maternal and neonatal morbidity, mortality, and long-term psychological impact. Data from the European INOSS network report an incidence of pH of 5.2 per 10,000 births, with notable variation between countries.Uterine atony and PAS are the leading indications, while major risk factors include advanced maternal age, multiparity, and especially prior caesarean section due to its association with abnormal placentation. Management of severe obstetric haemorrhage follows a multidisciplinary, stepwise process from medical therapy and conservative surgical techniques to hysterectomy when necessary. Differences in clinical definitions, access to interventional radiology, and availability of specialized centres affect comparability and outcomes.Improving maternal outcomes and reducing preventable PH requires strengthened population-based surveillance, standardized definitions and guidelines, multidisciplinary training, and structured psychosocial follow-up.</p>}},
author = {{Donati, Serena and Troìa, Libera and Alexander, Sophie and Ventura, Charles Savona and Kristufkova, Alexandra and Velebil, Petr and Zaigham, Mehreen and Mahmood, Tahir}},
issn = {{0301-2115}},
keywords = {{Massive haemorrhage; Maternalnear-miss; Obstetric complications; Obstetric surveillance; Peripartum hysterectomy; Placentaaccreta spectrum disorders}},
language = {{eng}},
publisher = {{Elsevier}},
series = {{European Journal of Obstetrics and Gynecology and Reproductive Biology}},
title = {{Rising global incidence of peripartum hysterectomy, how to address this challenge? An invited review by the European Board and College of Obstetrics and Gynaecology (EBCOG)}},
url = {{http://dx.doi.org/10.1016/j.ejogrb.2026.115232}},
doi = {{10.1016/j.ejogrb.2026.115232}},
volume = {{324}},
year = {{2026}},
}