Emergency and elective peripartum hysterectomy – the clinical experience of the Emergency University Hospital Bucharest

Peripartum hysterectomy remains a rare but critical sur­gi­cal procedure, typically performed in the context of se­vere obstetric hemorrhage unresponsive to conservative ma­nage­ment. This retrospective case series analyzes 15 pe­ri­par­tum hysterectomies performed over a 17-month pe­riod (January 2024 – May 2025) in a high-volume ter­tiary referral center. The overall incidence was 0.68%, with the most frequent indication being placenta praevia with or without abnormal placental adherence, followed by uterine atony, placental abruption, and one case of se­vere sepsis. The median maternal age was 32 years old, and caesarean delivery was the mode of birth in 14 out of 15 cases. Blood loss ranged from 2000 to 3800 mL, with variable transfusion requirements. Intensive care unit (ICU) admission was required in over 70% of patients, and hospital stays ranged between five and 28 days, with a median of 10 days. Despite the severity of the clinical scenarios, maternal sur­vi­val was 100%. These findings emphasize the need for early diagnosis, coordinated multidisciplinary care and in­sti­tu­tio­nal preparedness in managing patients at high risk for pe­ri­partum hysterectomy.