Uterine size and risk of complications among women undergoing abdominal hysterectomy for leiomyomas

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 87; no. 4; pp. 539 - 543
• Main Authors: Hillis, Susan D., Marchbanks, Polly A., Peterson, Herbert B.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.1996; The American College of Obstetricians and Gynecologists; Elsevier Science
• Subjects: Adult; Biological and medical sciences; Blood Transfusion; Female; Humans; Hysterectomy; Leiomyoma - pathology; Leiomyoma - surgery; Medical sciences; Organ Size; Postoperative Complications; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Uterine Neoplasms - pathology; Uterine Neoplasms - surgery; Uterus - pathology; Human; Leiomyoma; Measurement; Size; Intraoperative; Hysterectomy; Statistical study; Weight; Female genital diseases; Treatment; Uterus; Surgery; Cohort study; Risk factor; Uterine diseases; Complication; Female; Benign neoplasm
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1016/0029-7844(95)00478-5

To measure the influence of uterine size on the risk of operative complications among women undergoing abdominal hysterectomy for uterine leiomyomas. Four hundred forty-six women undergoing abdominal hysterectomy for pathologically confirmed leiomyomas were analyzed using data from a previously reported prospective cohort study. We compared the risk of operative complications among women with uterine weights less than 250 g, 251–500 g, and greater than 500 g. Logistic regression was used to estimate the independent effect of uterine size on the probability of operative complications. The risk of blood transfusion increased with increasing uterine weight; 13.7, 14.2, and 26.7% of women with uterine weight less than 250 g, 251–500 g, and greater than 500 g, respectively, required transfusion ( P for trend < .05). After adjustment for race, previous surgery, preoperative weight, concurrent endometriosis, and type of insurance coverage, women with uterine weight greater than 500 g had increased odds of having a transfusion (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.3–4.3). These women also had increased odds of having an estimated blood loss greater than 500 mL (OR 2.5, 95% CI 1.5–4.2), vaginal cuff cellulitis (OR 2.8, 95% CI 1.3–6.2), and at least one of a number of operative complications (OR 1.6, 95% CI 1.0–4.0). Women with leiomyomas whose uterine weight exceeds 500 g have an increased risk of complications from abdominal hysterectomy.