The impact of a previous cesarean section on the risk of perioperative and postoperative complications during vaginal hysterectomy

Moran Weiss, Yael Baumfeld, Reut Rotem, Yuval Gedalia, Miriam Erenberg, Adi Y. Weintraub

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To investigate whether a previous cesarean section increases the risk of perioperative and postoperative complications during vaginal hysterectomy. Methods: A retrospective cohort study of women who had undergone a vaginal hysterectomy for benign indications between 2014 and 2019 was conducted, comparing patients with or without a previous cesarean section. Perioperative and postoperative complications during vaginal hysterectomy were assessed according to the Clavien-Dindo classification system within 30 days of surgery. Duration of surgery, estimated blood loss, and postoperative hospitalization days were also recorded. A two-sided P value of less than 0.05 was considered significant. Results: A total of 185 women were included, 25 (13.5%) patients had undergone a previous cesarean section (study group) and 160 (86.5%) had no history of cesarean section (comparison group). We found no significant differences in demographic and clinical characteristics as well as postoperative complications and interventions, duration of surgery, estimated blood loss, and postoperative hospitalization days (P > 0.05). However, patients who underwent two or more cesarean sections had a significantly (P = 0.01) higher rate and grade of complications during vaginal hysterectomy, compared with women with only one previous cesarean section. All women who underwent two or more cesarean sections had mild complications during vaginal hysterectomy (40% grade I and 60% grade II, P = 0.01). Conclusion: Vaginal hysterectomy is a safe procedure with few severe complications, regardless of a previous cesarean section. More than one previous cesarean section may increase the risk of minor complications during a vaginal hysterectomy. Patients who underwent a previous cesarean section could be reassured that they do not face an increased risk of complications during a vaginal hysterectomy.

Original languageEnglish
Pages (from-to)557-562
Number of pages6
JournalInternational Journal of Gynecology and Obstetrics
Volume164
Issue number2
DOIs
StatePublished - 1 Feb 2024
Externally publishedYes

Keywords

  • clavien-Dindo classification
  • esarean sections
  • major surgical complications, minor surgical complications
  • previous cesarean section
  • previous two cesarean sections
  • vaginal hysterectomy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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