Estradiol vaginal tablet and conjugated estrogen cream were effective in treating urogenital symptoms, the restoration of normal vaginal epithelium and reduction of vaginal pH in postmenopausal women. However, 2 cases of endometrial proliferation were noted.

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Emergency peripartum hysterectomy was performed for management of intractable obstetric hemorrhage that was unresponsive to other treatment. The procedure is often associated with a relatively high morbidity and mortality, especially when performed under emergency life-threatening situation. Most current case series reported the incidence of 1-3 per 1000 deliveries [1][2][3][4]. This study was performed as case control study to evaluate data regarding the risk factors of emergency peripartum hysterectomy.The study design was a case-control study of pregnant women who delivered at Inclusion criteria was a pregnant woman who underwent emergency peripartum hysterectomy within 24 h after delivery which delivered a single infant or twins and gestational age z 28 weeks. The pregnant women who underwent elective cesarean hysterectomy or incomplete medical data were excluded. Computer-generated lists allowed randomization of two pregnant women who delivered at the same time of each case pregnant woman as control group with the same inclusion and exclusion criteria. Medical records were reviewed for maternal demographic data, obstetrical history, route of delivery, oxytocin usage, induction of labor, fetal birthweight, indication of hysterectomy, intraoperative and postoperative complications. Pathological reports of hysterectomy specimens were performed to confirm the indication of the procedure. All data were corrected in Epidata version 6.0 and then were analysed by Stata version 8.0. Multivariable analysis using logistic regression was carried out with emergency peripartum hysterectomy as the final outcome. Odds ratio (OR) and 95% confidence intervals (CI) were calculated using logistic regression; p value less than 0.05 was considered statistically significant.During the study period, there were fifty-seven cases that underwent emergency peripartum hys-0020-7292/$ -see front matter D