Association between peripartum hysterectomy and venous throm
The findings of this study demonstrate that peripartum hysterectomy is associated with a significantly increased risk of venous thromboembolism (VTE) in the postpartum period even when controlling for other known risk factors for postpartum thromboembolic events.

The objective of this study was to compare the incidence and risk of VTE among women who had and did not have a peripartum hysterectomy. They also sought to compare the risk of VTE after hysterectomy with other patients, pregnancy, and delivery risk factors are known to be associated with VTE.

The incidence of VTE during the delivery encounter and rehospitalizations within 6 weeks of discharge was compared among women who had and did not have a peripartum hysterectomy. Similarly, VTE risk by mode of delivery, including hysterectomy, were compared. Diagnoses that may have been indications for peripartum hysterectomy were identified among patients who underwent hysterectomy and compared between those who did and did not have VTE.

- The risk of VTE in women after hysterectomy was significantly higher compared to women who did not have a hysterectomy.

- Comparing VTE by mode of delivery, the unadjusted and adjusted incidences of VTE were: 6.9 and 7.4 per 10,000 deliveries among women after vaginal delivery without peripartum hysterectomy; 12.5 and 11.3 per 10,000 deliveries after cesarean delivery without hysterectomy; and 217.2 and 96.9 per 10,000 deliveries after hysterectomy, regardless of the mode of delivery.

- Of the 110 diagnoses of VTE with peripartum hysterectomy, 89 occurred during the delivery admission. Of the remaining 21, 50% occurred within the first 10 days after discharge from the delivery encounter, and 75% had occurred by 25 days after discharge.

In particular, the incidence of VTE following peripartum hysterectomy observed in our study population (2.2%) meets some guideline-based risk thresholds for routine thromboprophylaxis, potentially for at least two weeks postpartum.

Source: https://doi.org/10.1016/j.ajog.2021.06.091
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