Elective versus emergency cesarean hysterectomy on a teaching service--1981 to 1991.
We compared the differences in morbidity of elective and emergency cesarean hysterectomy (CH) in a training program. Records of patients who had elective or emergency CH were reviewed for information reflecting perioperative morbidity and fetal outcome. Eighty-eight CHs were elective and 18 were emergencies. Compared to emergency CHs, operative time for elective CHs was 30 minutes less, intraoperative blood loss was 700 mL lower, less postoperative blood replacement was needed, and hospital stay was 3.5 days shorter. Emergency CH had nearly twice the frequency of postoperative febrile morbidity and a three-times-higher rate of morbidity due to other causes. CHs were done at a gestational age of 36 or more weeks in 81.6% of elective cases, compared to only 50% of emergency cases. Mean birth weight of newborns delivered electively was 900 g higher, and Apgar scores were better. These data show that CHs done by house staff in training have a significantly lower complication rate when the operations are elective rather than emergent.
Lu
P Y
PY
Department of Obstetrics and Gynecology, Louisiana State University Medical Center, New Orleans 70112, USA.
Pastorek
J G
JG
Letellier
R L
RL
Bey
M A
MA
D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D002585:Cesarean Section / Q000009:adverse effects / Q000706:statistics & numerical data*; D004630:Emergencies; D005260:Female; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D007416:Intestinal Perforation / Q000209:etiology; D007902:Length of Stay; D008145:Louisiana; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D001743:Urinary Bladder / Q000293:injuries; D014591:Uterine Diseases / Q000601:surgery; D014592:Uterine Hemorrhage / Q000601:surgery