Adenomyosis among patients undergoing postpartum hysterectomy for uncontrollable uterine bleeding: A multicenter, observational, retrospective, cohort study on histologically‐based prevalence and clinical characteristics

Matteo Giorgi, Diego Raimondo, Martina Pacifici, Ludovica Bartiromo, Massimo Candiani, Francesco Fedele, Alessandra Pizzo, Herbert Valensise, Renato Seracchioli, Antonio Raffone, Francesco Giuseppe Martire, Gabriele Centini, Errico Zupi, Lucia Lazzeri
International Journal of Gynecology & Obstetrics · 2024 · vol. 166(2) , pp. 849–858 · doi:10.1002/ijgo.15452 · PMID:38494900 · W4392919772
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study found adenomyosis in 39.4% of patients undergoing postpartum hysterectomy for bleeding, associating it with longer hospital stays and increased risks of hypertensive disorders, preterm labor, emergency C-sections, maternal complications, and low birth weight neonates.

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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). CONCLUSION: 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.

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Hysterectomy Hysterectomy Hysterectomy Hysterectomy Hysterectomy Hysterectomy Postpartum Hemorrhage Postpartum Hemorrhage Postpartum Hemorrhage Postpartum Hemorrhage Postpartum Hemorrhage Postpartum Hemorrhage Adult Adult Adult

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