Number of previous cesarean deliveries and its effects on outcomes of vaginal hysterectomy

Background: This study aimed to compare the surgical outcomes of vaginal hysterectomy based on the number of previous cesarean delivery. Methods: A retrospective chart review was performed for all patients who underwent vaginal hysterectomy for non-prolapsed uterus between January 2016 and December...

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Main Authors: Hyesook Kim, Hye-yon Cho, Sung Taek Park, Sung-ho Park
Format: Article
Language:English
Published: IMR Press 2021-12-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/48/6/10.31083/j.ceog4806221
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author Hyesook Kim
Hye-yon Cho
Sung Taek Park
Sung-ho Park
author_facet Hyesook Kim
Hye-yon Cho
Sung Taek Park
Sung-ho Park
author_sort Hyesook Kim
collection DOAJ
description Background: This study aimed to compare the surgical outcomes of vaginal hysterectomy based on the number of previous cesarean delivery. Methods: A retrospective chart review was performed for all patients who underwent vaginal hysterectomy for non-prolapsed uterus between January 2016 and December 2019. Women with a history of other abdominal surgeries were excluded. Patient characteristics and surgical outcomes were compared based on the number of previous cesarean deliveries. Results: Among 610 women, 541 had no cesarean delivery, 39 had one cesarean delivery, and 30 had two or more cesarean deliveries. Patient characteristics, such as parity, body mass index, and uterine weight were similar, except for age (no section 49.2 ± 8.6 years old vs. one section 46.5 ± 5.2 years old vs. two sections 44.9 ± 4.4 years old; p = 0.004) and preoperative hemoglobin level (no section 12.0 ± 1.23 g/dL vs. one section 11.5 ± 1.44 g/dL vs. two sections 11.9 ± 1.13 g/dL; p = 0.014). Surgical outcomes, including surgery time, postoperative hospital stay and drop in hemoglobin level, and estimated blood loss were similar among the three groups. The intra- or post-operative transfusion rate was the highest in the one cesarean delivery group (no cesarean delivery 8.1% vs. one cesarean delivery 20.5% vs. two or more cesarean deliveries 3.3%; p = 0.017). Conclusion: Our data suggest that the number of previous cesarean deliveries did not affect the outcomes of vaginal hysterectomy. Vaginal hysterectomy can be performed safely even in women with two or more prior cesarean deliveries, when patients are selected appropriately by skilled surgeons.
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spelling doaj-art-cd83fb8076ef494abcef3990f6a4f2602025-08-20T03:48:32ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632021-12-014861400140310.31083/j.ceog4806221S0390-6663(21)01641-9Number of previous cesarean deliveries and its effects on outcomes of vaginal hysterectomyHyesook Kim0Hye-yon Cho1Sung Taek Park2Sung-ho Park3Institute of New Frontier Research Team, Hallym University, 24252 Chuncheon, Republic of KoreaDepartment of Obstetrics and Gynecology, Hallym University, 24252 Seoul, Republic of KoreaInstitute of New Frontier Research Team, Hallym University, 24252 Chuncheon, Republic of KoreaDepartment of Obstetrics and Gynecology, Hallym University, 24252 Seoul, Republic of KoreaBackground: This study aimed to compare the surgical outcomes of vaginal hysterectomy based on the number of previous cesarean delivery. Methods: A retrospective chart review was performed for all patients who underwent vaginal hysterectomy for non-prolapsed uterus between January 2016 and December 2019. Women with a history of other abdominal surgeries were excluded. Patient characteristics and surgical outcomes were compared based on the number of previous cesarean deliveries. Results: Among 610 women, 541 had no cesarean delivery, 39 had one cesarean delivery, and 30 had two or more cesarean deliveries. Patient characteristics, such as parity, body mass index, and uterine weight were similar, except for age (no section 49.2 ± 8.6 years old vs. one section 46.5 ± 5.2 years old vs. two sections 44.9 ± 4.4 years old; p = 0.004) and preoperative hemoglobin level (no section 12.0 ± 1.23 g/dL vs. one section 11.5 ± 1.44 g/dL vs. two sections 11.9 ± 1.13 g/dL; p = 0.014). Surgical outcomes, including surgery time, postoperative hospital stay and drop in hemoglobin level, and estimated blood loss were similar among the three groups. The intra- or post-operative transfusion rate was the highest in the one cesarean delivery group (no cesarean delivery 8.1% vs. one cesarean delivery 20.5% vs. two or more cesarean deliveries 3.3%; p = 0.017). Conclusion: Our data suggest that the number of previous cesarean deliveries did not affect the outcomes of vaginal hysterectomy. Vaginal hysterectomy can be performed safely even in women with two or more prior cesarean deliveries, when patients are selected appropriately by skilled surgeons.https://www.imrpress.com/journal/CEOG/48/6/10.31083/j.ceog4806221vaginal hysterectomycesarean deliverycontraindication
spellingShingle Hyesook Kim
Hye-yon Cho
Sung Taek Park
Sung-ho Park
Number of previous cesarean deliveries and its effects on outcomes of vaginal hysterectomy
Clinical and Experimental Obstetrics & Gynecology
vaginal hysterectomy
cesarean delivery
contraindication
title Number of previous cesarean deliveries and its effects on outcomes of vaginal hysterectomy
title_full Number of previous cesarean deliveries and its effects on outcomes of vaginal hysterectomy
title_fullStr Number of previous cesarean deliveries and its effects on outcomes of vaginal hysterectomy
title_full_unstemmed Number of previous cesarean deliveries and its effects on outcomes of vaginal hysterectomy
title_short Number of previous cesarean deliveries and its effects on outcomes of vaginal hysterectomy
title_sort number of previous cesarean deliveries and its effects on outcomes of vaginal hysterectomy
topic vaginal hysterectomy
cesarean delivery
contraindication
url https://www.imrpress.com/journal/CEOG/48/6/10.31083/j.ceog4806221
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