IMR Press / CEOG / Volume 48 / Issue 6 / DOI: 10.31083/j.ceog4806221
Open Access Original Research
Number of previous cesarean deliveries and its effects on outcomes of vaginal hysterectomy
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1 Institute of New Frontier Research Team, Hallym University, 24252 Chuncheon, Republic of Korea
2 Department of Obstetrics and Gynecology, Hallym University, 24252 Seoul, Republic of Korea
*Correspondence: vth2000@naver.com (Sung-ho Park); parkst96@naver.com (Sung Taek Park)
These authors contributed equally.
Clin. Exp. Obstet. Gynecol. 2021, 48(6), 1400–1403; https://doi.org/10.31083/j.ceog4806221
Submitted: 18 August 2021 | Revised: 30 September 2021 | Accepted: 27 October 2021 | Published: 15 December 2021
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

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.

Keywords
Vaginal hysterectomy
Cesarean delivery
Contraindication
Funding
NRF-2020R1G1A1005483/Korean government, Ministry of Science and ICT (MSIT)
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