Prior cesarean delivery and risk of conversion to laparotomy during laparoscopic hysterectomy

Deslyn T G Hobson, Anthony N. Imudia, Zain A. Al-Safi, George Shade, Michael Peter Diamond, Awoniyi O. Awonuga

Research output: Contribution to journalArticle

Abstract

Objective: The goal of this study was to test the hypothesis that a history of previous cesarean delivery does not increase the risk of conversion to laparotomy in patients undergoing laparoscopic supracervical hysterectomy (LSH) for benign gynecologic indications. Design: This was a retrospective cohort study. Materials and Methods: A retrospective cohort study was conducted of 799 patients who underwent LSH for benign gynecologic indications between January 2003 and December 2009. Results: There were a total of 16 (2%) conversions. The patients who underwent conversion were 5 times more likely to have a uterus that weighed ≥250 g (odds ratio [OR]: 5.2; 95% confidence interval [CI]: 1.8-17.4) and 3 times more likely to have had previous cesarean delivery (OR: 3.0; 95% CI: 1.1-8.0). These patients were also significantly more likely to need concomitant adhesiolysis in addition to the primary procedure (OR: 3.5; 95% CI: 1.2-9.8). However, after controlling for confounders (body mass index, blood loss, concomitant adhesiolysis, previous cesarean delivery, and uterine weight) only the presence of previous cesarean delivery ≥3 cesearean deliveries (adjusted odds ratio [AOR]: 6.41; 95% CI: 1.24-33.48; p=0.03) and uterine weight ≥250 g (AOR: 6.51; 95% CI: 1.74-24.38; p=0.005) were associated with conversion to laparotomy. Conclusions: The rate of conversion to laparotomy during LSH increases with history of ≥3 previous cesarean deliveries and uterine weight ≥250 g. (J GYNECOL SURG 29:275)

Original languageEnglish (US)
Pages (from-to)275-280
Number of pages6
JournalJournal of Gynecologic Surgery
Volume29
Issue number6
DOIs
StatePublished - Dec 1 2013
Externally publishedYes

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Hysterectomy
Laparotomy
Odds Ratio
Confidence Intervals
Weights and Measures
Cohort Studies
Retrospective Studies
Uterus
Body Mass Index

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Surgery

Cite this

Prior cesarean delivery and risk of conversion to laparotomy during laparoscopic hysterectomy. / Hobson, Deslyn T G; Imudia, Anthony N.; Al-Safi, Zain A.; Shade, George; Diamond, Michael Peter; Awonuga, Awoniyi O.

In: Journal of Gynecologic Surgery, Vol. 29, No. 6, 01.12.2013, p. 275-280.

Research output: Contribution to journalArticle

Hobson, Deslyn T G ; Imudia, Anthony N. ; Al-Safi, Zain A. ; Shade, George ; Diamond, Michael Peter ; Awonuga, Awoniyi O. / Prior cesarean delivery and risk of conversion to laparotomy during laparoscopic hysterectomy. In: Journal of Gynecologic Surgery. 2013 ; Vol. 29, No. 6. pp. 275-280.
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