Abstract：
OBJECTIVE: To assess the prevalence of adenomyosis at pathologic examination, and its association with obstetric complications, peripartum maternal clinical characteristics and neonatal birth weight in patients undergoing postpartum hysterectomy due to postpartum hemorrhage (PPH).
METHODS: A multicenter, observational, retrospective, cohort study was carried out including all women who underwent postpartum hysterectomy due to PPH at gestational week 23+0 or later, between January 2010 and May 2023. Patients were categorized into two groups based on the presence of adenomyosis at pathologic examination, and were compared for obstetric complications, peripartum maternal clinical characteristics, and neonatal birth weight.
RESULTS: The histologically-based prevalence of adenomyosis in patients undergoing postpartum hysterectomy due to PPH was 39.4%. Adenomyosis was associated with a longer hospitalization time (regression coefficient: 4.43 days, 95% CI: 0.34-8.52, P = 0.034) and a higher risk of hypertensive disorders (OR: 5.82, 95% CI: 1.38-24.46, P = 0.016), threatened preterm labor (OR: 3.34, 95% CI: 1.08-10.31, P = 0.036), urgent/emergency C-section (OR: 24.15, 95% CI: 2.60-223.96, P = 0.005), postpartum maternal complications (OR: 4.96, 95% CI: 1.48-16.67, P = 0.012), maternal intensive care unit admission (OR: 3.56, 95% CI: 1.05-12.05, P = 0.041), and low birth weight neonates (OR: 3.8, 95% CI: 1.32-11.02, P = 0.013).
CONCLUSIONS: In patients undergoing postpartum hysterectomy due to PPH, adenomyosis is a highly prevalent condition among, and is associated with adverse obstetric, maternal, and neonatal outcomes.
METHODS: A multicenter, observational, retrospective, cohort study was carried out including all women who underwent postpartum hysterectomy due to PPH at gestational week 23+0 or later, between January 2010 and May 2023. Patients were categorized into two groups based on the presence of adenomyosis at pathologic examination, and were compared for obstetric complications, peripartum maternal clinical characteristics, and neonatal birth weight.
RESULTS: The histologically-based prevalence of adenomyosis in patients undergoing postpartum hysterectomy due to PPH was 39.4%. Adenomyosis was associated with a longer hospitalization time (regression coefficient: 4.43 days, 95% CI: 0.34-8.52, P = 0.034) and a higher risk of hypertensive disorders (OR: 5.82, 95% CI: 1.38-24.46, P = 0.016), threatened preterm labor (OR: 3.34, 95% CI: 1.08-10.31, P = 0.036), urgent/emergency C-section (OR: 24.15, 95% CI: 2.60-223.96, P = 0.005), postpartum maternal complications (OR: 4.96, 95% CI: 1.48-16.67, P = 0.012), maternal intensive care unit admission (OR: 3.56, 95% CI: 1.05-12.05, P = 0.041), and low birth weight neonates (OR: 3.8, 95% CI: 1.32-11.02, P = 0.013).
CONCLUSIONS: In patients undergoing postpartum hysterectomy due to PPH, adenomyosis is a highly prevalent condition among, and is associated with adverse obstetric, maternal, and neonatal outcomes.
摘要：
目的：在病理检查中评估子宫腺肌病的患病率，以及它与产科并发症的关系，产后出血行子宫切除术(PPH)患者的围产期产妇临床特点及新生儿出生体重。
方法：多中心，观察,回顾性,进行了队列研究，包括所有在妊娠23+0周或更晚因PPH行产后子宫切除术的妇女，2010年1月至2023年5月。根据病理检查是否存在子宫腺肌病，将患者分为两组，并比较产科并发症，围产期产妇临床特点,和新生儿出生体重。
结果：基于组织学的子宫腺肌病在因PPH而接受产后子宫切除术的患者中的患病率为39.4%。子宫腺肌病与住院时间较长有关(回归系数:4.43天,95％CI：0.34-8.52，P=0.034）和高血压疾病的高风险（OR：5.82，95％CI：1.38-24.46，P=0.016），先兆早产（OR：3.34，95%CI：1.08-10.31，P=0.036），紧急/紧急剖腹产（OR：24.15，95％CI：2.60-223.96，P=0.005），产后产妇并发症(OR:4.96,95%CI:1.48-16.67,P=0.012),产妇重症监护病房（OR：3.56，95%CI：1.05-12.05，P=0.041），和低出生体重新生儿（OR：3.8，95％CI：1.32-11.02，P=0.013）。
结论：在因PPH而接受产后子宫切除术的患者中，子宫腺肌病是一种非常普遍的疾病，并与不良产科相关，母性,和新生儿结局。
方法：多中心，观察,回顾性,进行了队列研究，包括所有在妊娠23+0周或更晚因PPH行产后子宫切除术的妇女，2010年1月至2023年5月。根据病理检查是否存在子宫腺肌病，将患者分为两组，并比较产科并发症，围产期产妇临床特点,和新生儿出生体重。
结果：基于组织学的子宫腺肌病在因PPH而接受产后子宫切除术的患者中的患病率为39.4%。子宫腺肌病与住院时间较长有关(回归系数:4.43天,95％CI：0.34-8.52，P=0.034）和高血压疾病的高风险（OR：5.82，95％CI：1.38-24.46，P=0.016），先兆早产（OR：3.34，95%CI：1.08-10.31，P=0.036），紧急/紧急剖腹产（OR：24.15，95％CI：2.60-223.96，P=0.005），产后产妇并发症(OR:4.96,95%CI:1.48-16.67,P=0.012),产妇重症监护病房（OR：3.56，95%CI：1.05-12.05，P=0.041），和低出生体重新生儿（OR：3.8，95％CI：1.32-11.02，P=0.013）。
结论：在因PPH而接受产后子宫切除术的患者中，子宫腺肌病是一种非常普遍的疾病，并与不良产科相关，母性,和新生儿结局。
