Uterine size and risk of complications among women undergoing abdominal hysterectomy for leiomyomas.
OBJECTIVE
To measure the influence of uterine size on the risk of operative complications among women undergoing abdominal hysterectomy for uterine leiomyomas.


METHODS
Four hundred forty-six women undergoing abdominal hysterectomy for pathologically confirmed leiomyomas were analyzed using data from a previously reported prospective cohort study. We compared the risk of operative complications among women with uterine weights less than 250 g, 251-500 g, and greater than 500 g. Logistic regression was used to estimate the independent effect of uterine size on the probability of operative complications.


RESULTS
The risk of blood transfusion increased with increasing uterine weight; 13.7, 14.2, and 26.7% of women with uterine weight less than 250 g, 251-500 g, and greater than 500 g, respectively, required transfusion (P for trend < .05). After adjustment for race, previous surgery, preoperative weight, concurrent endometriosis, and type of insurance coverage, women with uterine weight greater than 500 g had increased odds of having a transfusion (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.3-4.3). These women also had increased odds of having an estimated blood loss greater than 500 mL (OR 2.5, 95% CI 1.5-4.2), vaginal cuff cellulitis (OR 2.8, 95% CI 1.3-6.2), and at least one of a number of operative complications (OR 1.6, 95% CI 1.0-4.0).


CONCLUSIONS
Women with leiomyomas whose uterine weight exceeds 500 g have an increased risk of complications from abdominal hysterectomy.
Hillis
S D
SD
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Marchbanks
P A
PA
Peterson
H B
HB
D000328:Adult; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007889:Leiomyoma / Q000473:pathology* / Q000601:surgery*; D009929:Organ Size; D011183:Postoperative Complications; D012307:Risk Factors; D014594:Uterine Neoplasms / Q000473:pathology* / Q000601:surgery*; D014599:Uterus / Q000473:pathology*