{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:00:21Z","timestamp":1790600421727,"version":"4.1.0"},"reference-count":26,"publisher":"Knowledge E DMCC","issue":"8","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":["knepublishing.com"],"crossmark-restriction":true},"short-container-title":["IJRM"],"abstract":"<jats:p>Background: Cesarean hysterectomy (CH) is a life-saving surgical procedure performed in obstetric emergencies, particularly in cases of uncontrollable hemorrhage, placenta previa, and abnormal placental adherence.\r\nObjective: This study aimed to evaluate the maternal characteristics, associated clinical factors, complications, and neonatal outcomes observed in CH.\r\nMaterials and Methods: In this cross-sectional study, data of 89 women who underwent CH at Sayad Shirazi hospital, Gorgan, Iran, between 2013 and 2022 were extracted from participants\u2019 medical records using a structured checklist covering maternal demographics, comorbidities, placental conditions, surgical outcomes, and neonatal results.\r\nResults: The mean maternal age was 34.65 \u00b1 5.2 yr, body mass index 28.78 \u00b1 3.4 kg\/m\u00b2, and gestational age 34.54 \u00b1 3.2 wk. Placenta previa was present in 88.6% of cases, with placenta increta (46.1%), accreta (29.2%), and percreta (21.3%) being the most common placenta accreta spectrum subtypes. Preoperative and postoperative hemoglobin levels were 11.2 \u00b1 1.8 and 8.15 \u00b1 1.56 g\/dL, respectively. Blood transfusion was required in 94.4% of cases. Intensive care unit admission was required in 93.3%, with a mean stay of 2.01 \u00b1 0.11 days. Intraoperative organ injury occurred in 20.2% of cases. Mean neonatal birth weight was 2414.61 \u00b1 682 gr, with 68.1% requiring neonatal intensive care unit admission primarily due to prematurity. No maternal or neonatal deaths occurred.\r\nConclusion: Placenta previa and placenta accreta spectrum disorders are the primary risk factors for CH. Adequate preparation, including blood product reserves and intensive care unit\/neonatal intensive care unit availability, is essential for managing these high-risk cases. As a descriptive study without a comparison group, these findings reflect observed patterns rather than causal associations.<\/jats:p>","DOI":"10.18502\/ijrm.v24i8.21667","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T12:15:28Z","timestamp":1790597728000},"update-policy":"https:\/\/doi.org\/10.18502\/knecrossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Maternal characteristics, clinical indications, and neonatal outcomes in cesarean hysterectomy: A cross-sectional study"],"prefix":"10.18502","volume":"24","author":[{"given":"Farahnazsadat","family":"Ahmadi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behnaz","family":"Behzadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahboubeh","family":"Tajaldini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"7770","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"343861","doi-asserted-by":"crossref","unstructured":"[1] Sayma A, Ara G. Assessment of the cases undergone peripartum hysterectomy in a tertiary care hospital in the last three years. Open J Obstet Gynecol 2018; 8: 1006\u20131014.","DOI":"10.4236\/ojog.2018.811101"},{"key":"343862","doi-asserted-by":"crossref","unstructured":"[2] Mansouri Gh, Karami Robati F, Dehghani A, Golnarges F, Salehiniya H, Alkatout I, et al. Causes and factors affecting cesarean hysterectomy: A retrospective study. Medicina (Kaunas) 2025; 61: 371.","DOI":"10.3390\/medicina61030371"},{"key":"343863","doi-asserted-by":"crossref","unstructured":"[3] Lin C-H, Long C-Y, Huang K-H, Lo T-S, Wu M-P. Surgical trend and volume effect on the choice of hysterectomy benign gynecologic conditions. Gynecol Minim Invasive Ther 2021; 10: 1\u20139.","DOI":"10.4103\/GMIT.GMIT_68_20"},{"key":"343864","doi-asserted-by":"crossref","unstructured":"[4] Radmehr Z, Zarshenas M, Keshavarz M, Akbarzadeh M. Comparison of the quality of life and post-traumatic stress in postmenopausal and non-menopausal women after hysterectomy in selected hospitals of Shiraz University of Medical Sciences in 2020. Current Women\u2018s Health Reviews 2023; 19: 101\u2013108.","DOI":"10.2174\/1573404818666220505154823"},{"key":"343865","doi-asserted-by":"crossref","unstructured":"[5] Boerma T, Ronsmans C, Melesse DY, Barros AJD, Barros FC, Juan L, et al. Global epidemiology of use of and disparities in caesarean sections. Lancet 2018; 392: 1341\u20131348.","DOI":"10.1016\/S0140-6736(18)31928-7"},{"key":"343866","doi-asserted-by":"crossref","unstructured":"[6] Betran AP, Ye J, Moller A-B, Souza JP, Zhang J. Trends and projections of caesarean section rates: Global and regional estimates. BMJ Glob Health 2021; 6: e005671.","DOI":"10.1136\/bmjgh-2021-005671"},{"key":"343867","doi-asserted-by":"crossref","unstructured":"[7] Jauniaux E, Chantraine F, Silver RM, Langhoff-Roos J, FIGO placenta accreta diagnosis and management expert consensus panel. FIGO consensus guidelines on placenta accreta spectrum disorders: Epidemiology. Int J Gynaecol Obstet 2018; 140: 265\u2013273.","DOI":"10.1002\/ijgo.12407"},{"key":"343868","unstructured":"[8] Gandikota S, Yada BB, Mohite U. A study on intra and postoperative complications of emergency peripartum hysterectomy in a tertiary care centre. Int J Pharm Res Technol 2024; 14: 1379\u20131385."},{"key":"343869","unstructured":"[9] Nyime JM. Incidence of emergency peripartum hysterectomy in Kenyatta National hospital [M.Sc. thesis]. University of Nairobi; 2021."},{"key":"343870","doi-asserted-by":"crossref","unstructured":"[10] Yang C-C, Chou Y-C, Kuo T-N, Liou J-Y, Cheng H-M, Kuo Y-T. Prophylactic intraoperative uterine artery embolization during cesarean section or cesarean hysterectomy in patients with abnormal placentation: A systematic review and meta-analysis. Cardiovasc Intervent Radiol 2022; 45: 488\u2013501.","DOI":"10.1007\/s00270-021-02921-2"},{"key":"343871","unstructured":"[11] Cianci V, Mondello C, Sapienza D, Genazzani AD, Tornese L, Cianci A, et al. Uterine atony and postpartum haemorrhage: Predisposing genetic factors, and postmortem findings. Clin Ter 2025; 176: 468\u2013477."},{"key":"343872","doi-asserted-by":"crossref","unstructured":"[12] Kallianidis AF, Rijntjes D, Brobbel C, Dekkers OM, Bloemenkamp KWM, Van Den Akker T. Incidence, indications, risk factors, and outcomes of emergency peripartum hysterectomy worldwide: A systematic review and meta-analysis. Obstet Gynecol 2023; 141: 35\u201348.","DOI":"10.1097\/AOG.0000000000005022"},{"key":"343873","doi-asserted-by":"crossref","unstructured":"[13] Ma G, Yang Y, Fu Q. The incidence, indications, risk factors and pregnancy outcomes of peripartum hysterectomy at a tertiary hospital between 2013 and 2022. Arch Gynecol Obstet 2024; 310: 145\u2013151.","DOI":"10.1007\/s00404-023-07276-2"},{"key":"343874","doi-asserted-by":"crossref","unstructured":"[14] de Vries PLM, Verspyck E, Morau E, Saucedo M, Deneux-Tharaux C, ENCMM study group. Maternal mortality due to obstetric hemorrhage by surgical injury during cesarean section: A nationwide study. Acta Obstet Gynecol Scand 2024; 103: 1877\u20131887.","DOI":"10.1111\/aogs.14917"},{"key":"343875","doi-asserted-by":"crossref","unstructured":"[15] Tsolakidis D, Zouzoulas D, Pados G. Pregnancy-related hysterectomy for peripartum hemorrhage: A literature narrative review of the diagnosis, management, and techniques. Biomed Res Int 2021; 2021: 9958073.","DOI":"10.1155\/2021\/9958073"},{"key":"343876","doi-asserted-by":"crossref","unstructured":"[16] Jaiyesimi RA, Ojo OE, Awe AF. Caesarean delivery and peripartum hysterectomy. In: Okonofua F, Balogun JA, Odunsi K, Chilaka VN. Contemporary obstetrics and gynecology for developing countries. Switzerland: Springer; 2021: 203\u2013221.","DOI":"10.1007\/978-3-030-75385-6_18"},{"key":"343877","doi-asserted-by":"crossref","unstructured":"[17] Al-Rabeei NAJ. Emergency cesarean hysterectomy among women attending to obstetric unit in Al-Thowrah hospital, Sana\u2019a city, Yemen. Sana\u2019a Univ J Med Health Sci 2023; 2: 8\u201315.","DOI":"10.59628\/jchm.v2i1.304"},{"key":"343878","doi-asserted-by":"crossref","unstructured":"[18] Kumari P, Kundu J. Prevalence, socio-demographic determinants, and self-reported reasons for hysterectomy and choice of hospitalization in India. BMC Womens Health 2022; 22: 514.","DOI":"10.1186\/s12905-022-02072-7"},{"key":"343879","doi-asserted-by":"crossref","unstructured":"[19] Jakobsson M, Tapper A-M, Colmorn LB, Lindqvist PG, Klungs\u00f8yr K, Krebs L, et al. Emergency peripartum hysterectomy: Results from the prospective Nordic obstetric surveillance study (NOSS). Acta Obstet Gynecol Scand 2015; 94: 745\u2013754.","DOI":"10.1111\/aogs.12644"},{"key":"343880","doi-asserted-by":"crossref","unstructured":"[20] Bluth A, Schindelhauer A, Nitzsche K, Wimberger P, Birdir C. Placenta accreta spectrum disorders-experience of management in a German tertiary perinatal centre. Arch Gynecol Obstet 2021; 303: 1451\u20131460.","DOI":"10.1007\/s00404-020-05875-x"},{"key":"343881","doi-asserted-by":"crossref","unstructured":"[21] Kasraeian M, Hashemi A, Hessami K, Moradi Alamdarloo S, Vahdani R, Vafaei H, et al. A 5-year experience on perinatal outcome of placenta accreta spectrum disorder managed by cesarean hysterectomy in southern Iranian women. BMC Womens Health 2021; 21: 243.","DOI":"10.1186\/s12905-021-01389-z"},{"key":"343882","doi-asserted-by":"crossref","unstructured":"[22] Kong X, Kong Y, Yan J, Hu J-J, Wang F-F, Zhang L. On opportunity for emergency cesarean hysterectomy and pregnancy outcomes of patients with placenta accreta. Medicine (Baltimore) 2017; 96: e7930.","DOI":"10.1097\/MD.0000000000007930"},{"key":"343883","doi-asserted-by":"crossref","unstructured":"[23] Cao X, Liu X, Zhang X, Zhang K, Chen C, Yang Q, et al. Risk factors for perioperative blood transfusion in patients undergoing total laparoscopic hysterectomy. BMC Womens Health 2024; 24: 65.","DOI":"10.1186\/s12905-024-02908-4"},{"key":"343884","doi-asserted-by":"crossref","unstructured":"[24] Flores-Mendoza H, Chandran AR, Hernandez-Nieto C, Murji A, Allen L, Windrim RC, et al. Outcomes in emergency versus electively scheduled cases of placenta accreta spectrum disorder managed by cesarean-hysterectomy within a multidisciplinary care team. Int J Gynecol Obstet 2022; 159: 404\u2013411.","DOI":"10.1002\/ijgo.14121"},{"key":"343885","unstructured":"[25] Yazdani SH, Yousofniya Pasha YR, Bouzari Z, Babazadeh A. [Emergency peripartum hysterectomy in north of Iran]. J Babol Univ Med Sci 2013; 15: 81\u201387. (In Persian)"},{"key":"343886","doi-asserted-by":"crossref","unstructured":"[26] Nguyen PN, Vuong ADB, Pham XTT. Neonatal outcomes in the surgical management of placenta accreta spectrum disorders: A retrospective single-center observational study from 468 Vietnamese pregnancies beyond 28 weeks of gestation. 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