NEW YORK (Reuters Health) - It is “uncommon, but not rare” for women to require removal of the uterus — known as hysterectomy — following cesarean deliveries, a study in the journal Obstetrics & Gynecology has found.
Such hysterectomies are usually a doctor’s response to heavy and dangerous bleeding following a cesarean delivery. The rate of hysterectomies has declined over the past decade, note Dr. Cynthia S. Shellhaus from The Ohio State University College of Medicine, Columbus, and colleagues, but their study found that the procedures still occur in one in 200 such deliveries.
The researchers identified 39,244 women who underwent cesarean delivery at 13 academic medical centers between 1999 and 2000. Among them, 186 of also required hysterectomies.
Women who had prior cesarean deliveries were more likely to undergo hysterectomy: 0.3 percent for no previous cesareans to 2.9 percent for women with three or more prior procedures. Nearly half (46 percent) occurred in patients who delivered at a gestational age less than 37 weeks.
Most of the hysterectomies were performed because of blood loss requiring transfusion, and three of the women died.
“The present analysis may serve as a reference to health care providers and women in determining risk for cesarean hysterectomy and its attendant complications,” Shellhaus and her team concludes.
SOURCE: Obstetrics and Gynecology, August 2009.