Obstetric Hysterectomy at a Greek Tertiary Referral Center: Differences in Maternal and Neonatal Outcomes Between Elective and Urgent Procedures
- 12nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Faculty of Health Sciences, Medical School, General Hospital of Thessaloniki “Ippokratio”, 54642 Thessaloniki, Greece
- 2Department of Hygiene and Epidemiology, University of Ioannina, Medical School, 45500 Ioannina, Greece
- 31st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Faculty of Health Sciences, Medical School, General Hospital of Thessaloniki “Papageorgiou”, 56403 Thessaloniki, Greece
Abstract
Background: Obstetric hysterectomy remains a life-saving intervention for placenta accreta spectrum and uncontrolled obstetric hemorrhage. Evidence regarding the outcomes of planned versus urgent obstetric hysterectomy in contemporary tertiary practice in Greece remains limited. We compared maternal and neonatal outcomes between elective and urgent procedures at a tertiary referral center in Thessaloniki. Methods: We retrospectively reviewed 30 women who underwent obstetric hysterectomy between January 2020 and June 2025. The elective group included women with prenatal PAS diagnosis and planned delivery at ≥34 weeks (n = 17), whereas the urgent group included women requiring unplanned delivery for hemorrhage or active labor without prior surgical preparation (n = 13). Maternal characteristics, intraoperative findings, transfusion requirements, complications, hospital stay, and neonatal outcomes were compared using bivariate statistical tests. Results: Maternal age was similar between groups (36.1 ± 6.1 vs. 37.9 ± 6.8 years; p = 0.44). Elective cases had higher parity (median 3 vs. 1; p = 0.002), had more previous cesarean deliveries (median 2 vs. 0; p = 0.002), and were more frequently diagnosed with placenta previa (p = 0.027). Uterine atony occurred more often in urgent cases (p < 0.001). Bakri balloon tamponade was used only in urgent cases and failed to control hemorrhage (p < 0.001). Operative time, transfusion requirement, hospital stay, and urinary tract injury rates were comparable. No maternal deaths occurred. Birth weight, Apgar scores, and NICU admission rates were also similar. Conclusions: Planned obstetric hysterectomy within a multidisciplinary setting was associated with fewer emergency hemorrhage-control interventions, while major perioperative and neonatal outcomes were comparable between groups.
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BibTeX
@article{flindris2026obstetric,
title = {{Obstetric Hysterectomy at a Greek Tertiary Referral Center: Differences in Maternal and Neonatal Outcomes Between Elective and Urgent Procedures}},
author = {Stefanos Flindris and Margioula-Siarkou Chrysoula and Konstantinos Christopoulos and Georgia Margioula-Siarkou and Ioannis Chatzikalogiannis and Michail Kalinderis and Alexandros Traianos and Elif Empliouk and Konstantinos Pantazis and Alexandros Sotiriadis and Konstantinos Dinas and Stamatios Petousis},
journal = {Journal of clinical medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15197738},
url = {https://europepmc.org/article/PMC/PMC13666389},
note = {CC BY},
}
RIS
TY - JOUR
TI - Obstetric Hysterectomy at a Greek Tertiary Referral Center: Differences in Maternal and Neonatal Outcomes Between Elective and Urgent Procedures
AU - Stefanos Flindris
AU - Margioula-Siarkou Chrysoula
AU - Konstantinos Christopoulos
AU - Georgia Margioula-Siarkou
AU - Ioannis Chatzikalogiannis
AU - Michail Kalinderis
AU - Alexandros Traianos
AU - Elif Empliouk
AU - Konstantinos Pantazis
AU - Alexandros Sotiriadis
AU - Konstantinos Dinas
AU - Stamatios Petousis
PY - 2026
DA - 2026/10/01
JO - Journal of clinical medicine
DO - 10.3390/jcm15197738
UR - https://europepmc.org/article/PMC/PMC13666389
AB - Background: Obstetric hysterectomy remains a life-saving intervention for placenta accreta spectrum and uncontrolled obstetric hemorrhage. Evidence regarding the outcomes of planned versus urgent obstetric hysterectomy in contemporary tertiary practice in Greece remains limited. We compared maternal and neonatal outcomes between elective and urgent procedures at a tertiary referral center in Thessaloniki. Methods: We retrospectively reviewed 30 women who underwent obstetric hysterectomy between January 2020 and June 2025. The elective group included women with prenatal PAS diagnosis and planned delivery at ≥34 weeks (n = 17), whereas the urgent group included women requiring unplanned delivery for hemorrhage or active labor without prior surgical preparation (n = 13). Maternal characteristics, intraoperative findings, transfusion requirements, complications, hospital stay, and neonatal outcomes were compared using bivariate statistical tests. Results: Maternal age was similar between groups (36.1 ± 6.1 vs. 37.9 ± 6.8 years; p = 0.44). Elective cases had higher parity (median 3 vs. 1; p = 0.002), had more previous cesarean deliveries (median 2 vs. 0; p = 0.002), and were more frequently diagnosed with placenta previa (p = 0.027). Uterine atony occurred more often in urgent cases (p < 0.001). Bakri balloon tamponade was used only in urgent cases and failed to control hemorrhage (p < 0.001). Operative time, transfusion requirement, hospital stay, and urinary tract injury rates were comparable. No maternal deaths occurred. Birth weight, Apgar scores, and NICU admission rates were also similar. Conclusions: Planned obstetric hysterectomy within a multidisciplinary setting was associated with fewer emergency hemorrhage-control interventions, while major perioperative and neonatal outcomes were comparable between groups.
SN - 2077-0383
ER -