{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T22:40:33Z","timestamp":1790635233607,"version":"4.1.0"},"reference-count":23,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Cesarean hysterectomy is a critical intervention often required to manage life-threatening postpartum hemorrhage (PPH) due to complications such as uterine atony, abnormal placental implantation, or traumatic rupture. Although lifesaving, the procedure is associated with significant risks and complications. This study investigates the causes and outcomes of cesarean hysterectomy, focusing on complications arising from the procedure. Materials and Methods: A retrospective analysis was conducted on 82 women who underwent cesarean hysterectomy at Afzali Pour Hospital between 2018 and 2022. All patients were followed for 42 days post-surgery to evaluate outcomes and complications. Data were extracted from electronic medical records, encompassing demographic, obstetric, and clinical details, including age, body mass index, previous cesarean sections, indications for cesarean deliveries, causes of hysterectomy, and complications. The primary outcome was to determine the causes of cesarean hysterectomy, while the secondary outcome assessed the complications associated with the procedure. Stepwise logistic regression analysis was utilized to identify significant predictors of complications. Results: The study included 82 women who underwent cesarean hysterectomy. The mean age of the participants was 35.2 years (SD = 5.4), with a range from 24 to 48 years. The average BMI was 29.1 kg\/m2 (SD = 4.3), with 45% of the women classified as overweight or obese (BMI \u2265 25). The majority of the patients (70%) had a history of two or more previous cesarean sections, and the most common indication for cesarean hysterectomy was abnormal placentation, including placenta accreta (58%). Uterine rupture was reported in 13% of the cases. In terms of complications, bladder injury was the most common, occurring in 33.33% of women, followed by fever (20%), ureteral injury (13.33%), and hematoma (8.89%). Stepwise logistic regression analysis revealed that higher BMI significantly increased the odds of the outcome (OR = 4.18, 95% CI: 1.66\u201310.51, p = 0.002), and the number of previous cesarean sections was also a significant predictor (OR = 2.30, 95% CI: 1.17\u20134.53, p = 0.016). Conclusions: Placenta accreta and previa were the most frequent causes of cesarean hysterectomy, with bladder injury and fever being the most common complications. A higher number of previous cesareans and higher BMI significantly increase the likelihood of complications. Understanding these risk factors can improve patient management and surgical outcomes, highlighting the importance of careful monitoring and preoperative planning in women with a history of cesarean deliveries.<\/jats:p>","DOI":"10.3390\/medicina61030371","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T06:10:21Z","timestamp":1740031821000},"page":"371","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Causes and Factors Affecting Cesarean Hysterectomy: A Retrospective Study"],"prefix":"10.3390","volume":"61","author":[{"given":"Ghazal","family":"Mansouri","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman 76169-13555, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0193-664X","authenticated-orcid":false,"given":"Fatemeh","family":"Karami Robati","sequence":"additional","affiliation":[{"name":"Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman 7616913555, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azam","family":"Dehghani","sequence":"additional","affiliation":[{"name":"Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman 7616913555, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faezeh","family":"Golnarges","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman 76169-13555, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid","family":"Salehiniya","sequence":"additional","affiliation":[{"name":"Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand 9717853577, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7194-6034","authenticated-orcid":false,"given":"Ibrahim","family":"Alkatout","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9851-6771","authenticated-orcid":false,"given":"Leila","family":"Allahqoli","sequence":"additional","affiliation":[{"name":"Ministry of Health, Treatment and Medical Education, Tehran 1419943471, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"key":"ref_1","unstructured":"Cunningham, F., Leveno, K., Hoffman, B., Spong, C., and Casey, B. 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