Uterine Prolapse in Pregnancy: National Trends, Risk Factors, and Obstetric Outcomes [A141].

INTRODUCTION: The uterus can prolapse acutely during pregnancy. We report national trends, characteristics, and obstetric outcomes of women with uterine prolapse (UP). METHODS: Retrospective cohort study using the HCUP-NIS database. Our study cohort included women admitted for delivery between 2004 and 2014 inclusively and had a diagnosis of UP. Multivariate logistic regression analyses compared obstetric outcomes among pregnancies complicated by UP versus those without, while adjusting for confounding variables. RESULTS: Among the 9,096,788 deliveries during our study period, 713 received a diagnosis of UP. The incidence of UP increased over time (P ≤0.0001). Women with UP were likelier to be older, multigravida, smokers, have endometriosis, or fibroids (P ≤0.002, all). They were less likely to have had a previous cesarean delivery (CD) (P <.0001), or multiple gestation (P =.03). Women with UP had lower odds of pregnancy-induced hypertension (aOR, 0.38; 95% CI, 0.25–0.58), preeclampsia (aOR, 0.27; 95% CI, 0.13–0.57), operative vaginal delivery (aOR, 0.41; 95% CI, 0.26–0.64), and CD (aOR, 0.30; 95% CI, 0.23–0.39). They had higher odds of having a spontaneous vaginal delivery (aOR, 3.46; 95% CI, 2.73–4.39), para-delivery hysterectomy (aOR, 21.5; 95% CI, 11.78–29.25), postpartum hemorrhage (aOR, 2.12; 95% CI, 1.56–2.87), wound complications (aOR, 2.72; 95% CI, 1.22–6.09), blood transfusion (aOR, 2.39; 95% CI, 1.43–3.10) or birth of neonates with major congenital abnormalities (aOR, 2.48; 95% CI, 1.18–5.22). CONCLUSION: Women with UP are at higher risk of obstetric complications and neonatal morbidity. These findings elucidate risk factors that may improve prenatal counseling, perinatal surgical management, and clinical practice and policy guidelines. [ABSTRACT FROM AUTHOR]