{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:30:37Z","timestamp":1792665037247,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,5,25]],"date-time":"2019-05-25T00:00:00Z","timestamp":1558742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology & Obste"],"published-print":{"date-parts":[[2019,7]]},"abstract":"Abstract<\/jats:title>Objective<\/jats:title>To determine incidence, risk indicators, and outcomes of emergency peripartum hysterectomy (EPH<\/jats:styled-content>) in Metro East, Cape Town, South Africa.<\/jats:p><\/jats:sec>Methods<\/jats:title>A population\u2010based district\u2010wide prospective descriptive study of EPH<\/jats:styled-content> in public hospitals from November 2014 to November 2015. Women were enrolled by using the WHO<\/jats:styled-content> maternal near miss tool and followed until discharge. EPH<\/jats:styled-content> was defined as hemorrhage or infection leading to hysterectomy during pregnancy or within 42\u00a0days of delivery.<\/jats:p><\/jats:sec>Results<\/jats:title>Fifty\u2010nine women experienced EPH<\/jats:styled-content> with an overall incidence of 14.3 per 10\u00a0000 women: 32 procedures were for postpartum hemorrhage, 27 for puerperal sepsis. Two women died: one from sepsis; one from hemorrhage. Overall, 51 (86%) women delivered by cesarean, and 23\/51 (45%) by repeat cesarean. As compared with hemorrhage, EPH<\/jats:styled-content> for sepsis involved older women (mean age, 31.5 vs 24.4\u00a0years) and those with higher gravidity (median, 3 vs 1), and was associated with longer hospital admission (median, 11.5 vs 4\u00a0days), with occurrence later postpartum (median, 8 vs 0\u00a0days), and more frequently with complications.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The incidence of EPH<\/jats:styled-content> for sepsis was higher than previously reported. Repeat cesarean was strongly associated with EPH<\/jats:styled-content>. Clinical characteristics of sepsis\u2010related EPH<\/jats:styled-content> compared unfavorably with those of hemorrhage\u2010related EPH<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.12837","type":"journal-article","created":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T15:40:53Z","timestamp":1557157253000},"page":"103-109","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["A district\u2010wide population\u2010based descriptive study of emergency peripartum hysterectomy in a middle\u2010income country"],"prefix":"10.1002","volume":"146","author":[{"given":"Anke","family":"Heitkamp","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Stellenbosch University and Tygerberg Academic Hospital Cape Town South Africa"},{"name":"Department of Obstetrics and Gynecology Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam the\u00a0Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorrit","family":"Seinstra","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"van den Akker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Vollmer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Stellenbosch University and Tygerberg Academic Hospital Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Gebhardt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Stellenbosch University and Tygerberg Academic Hospital Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos","family":"van Roosmalen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Leiden University Medical Center Leiden the Netherlands"},{"name":"Athena Institute Vrije Universiteit Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna I.","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam the\u00a0Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Theron","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Stellenbosch University and Tygerberg Academic Hospital Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001736"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-015-3790-2"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181cfc007"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2005.06.012"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2013-0348"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.5144\/0256-4947.2003.135"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000296658.83240.6d"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01507.x"},{"issue":"150","key":"e_1_2_7_10_1","first-page":"e1","article-title":"Peripartum hysterectomy and arterial embolization for major obstetric hemorrhage: A 2\u2010year nationwide cohort study in the Netherlands","volume":"202","author":"Zwart JJ","year":"2010","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-13-141"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldg007"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2003.03044.x"},{"key":"e_1_2_7_14_1","unstructured":"HeitkampA VollmerL GebhardtS.Severe acute maternal morbidity in the Metro East: study protocol: 1\u201336. Stellenbosch University and VU Medical Centre."},{"key":"e_1_2_7_15_1","unstructured":"PattinsonRC.Saving Mothers 2011\u20132013: The Sixth Report of the National Committee for Confidential Enquiries into Maternal Deaths in South Africa. Health D of editor. Pretoria Republic of South Africa: Government Printer;2014.http:\/\/www.kznhealth.gov.za\/mcwh\/Maternal\/Saving-Mothers-2011-2013-short-report.pdf."},{"key":"e_1_2_7_16_1","volume-title":"Evaluating the Quality of Care for Severe Pregnancy Complications: The WHO Near\u2010Miss Approach for Maternal Health","author":"Department of Reproductive Health and Research WHO","year":"2011"},{"key":"e_1_2_7_17_1","unstructured":"The World Bank.Country and Lending Groups 2016[Internet]. World Bank Atlas.2016.http:\/\/data.worldbank.org\/about\/country-and-lending-groups#Upper_middle_income. Accessed Mar 21 2016."},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31816569f2"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-014-3487-y"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-013-3079-2"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-015-1376-4"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.3109\/01443615.2011.560300"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181a81cdd"},{"key":"e_1_2_7_24_1","first-page":"394","article-title":"Defining definitions: A Delphi study to develop a core outcome set for conditions of severe maternal morbidity","author":"Schaap T","year":"2017","journal-title":"BJOG"}],"container-title":["International Journal of Gynecology & Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.12837","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.12837","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.12837","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T05:50:31Z","timestamp":1693893031000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.12837"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,25]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1002\/ijgo.12837"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.12837","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,25]]},"assertion":[{"value":"2018-10-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}