Outcome Better with Planned Caesarean Hysterectomy

Less blood loss, fewer complications compared with emergent surgery

THURSDAY, Aug. 23 (HealthDay News) -- A planned Caesarean hysterectomy results in less blood loss, fewer transfusions and lower rates of complications compared with emergent Caesarean hysterectomy, researchers report in the August issue of the American Journal of Obstetrics & Gynecology.

Christian M. Briery, M.D., of the University of Mississippi Medical Center in Jackson, Miss., and colleagues reviewed data gathered over a five-year period on 65 cases of Caesarean hysterectomy, of which 30 were planned and 35 were emergent.

Patients who underwent emergent Caesarean hysterectomy had an estimated blood loss of 2,597 mL versus 1,963 mL for those whose hysterectomies were planned. The blood transfusion rates were 66 percent and 33 percent for emergent and planned hysterectomies, respectively, and 66 percent of emergent cases resulted in complications versus 37 percent for planned cases.

Physicians caring for patients who are at risk for hysterectomy at the time of Caesarean should be well-prepared for the procedure and catastrophic obstetric hemorrhage, the authors note. "Furthermore, performing Caesarean hysterectomy under relatively controlled circumstances allows the surgeon to become more familiar with the operative technique," they conclude.

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