Previous cesarean section. A contraindication to vaginal hysterectomy?
OBJECTIVE
To compare surgical outcomes of vaginal hysterectomy between women who have had one or more cesarean deliveries and those who have not.


METHODS
A retrospective, chart review study was performed on women undergoing vaginal hysterectomy during a four-year period. Of 275 women who met the study criteria, 104 had a history of previous cesarean deliveries, and 171 did not. The groups were compared for indications for surgery, operative time, length of hospitalization and surgical complications.


RESULTS
Previous cesarean delivery did not affect hemoglobin loss, hospital stay or operative time among women undergoing vaginal hysterectomy. The complication rate (either operative or postoperative) was 12.3% among women without a history of cesarean section, 6.8% among those with one, 3.7% among those with two and 11.1% among those with three or more (chi 2 = 2.8, P = .4). The odds for surgical complications were not significantly different between women with one or more prior cesarean deliveries as compared to those without after adjustment for possible confounders.


CONCLUSIONS
Surgical complications with vaginal hysterectomy do not appear to be higher among women with a prior cesarean section as compared to those without a history of such operation.
Poindexter
Y M
YM
Department of Obstetrics and Gynecology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
Sangi-Haghpeykar
H
H
Poindexter
A N
AN
Thomakos
N
N
Young
R L
RL
Fine
P M
PM
Miller
H J
HJ
D000328:Adult; D000368:Aged; D002585:Cesarean Section; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects* / Q000191:economics; D007902:Length of Stay; D008499:Medical Records; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology; D016896:Treatment Outcome