RADICAL HYSTERECTOMY DURING PREGNANCY

To study the morbidity of radical hysterectomy during pregnancy, the c harts of all 10 women undergoing radical hysterectomy during pregnancy from September 1, 1991, through April 30, 1995, were reviewed. These were cohort matched from a group of 212 nonpregnant (NP) radical hyste rectomy patients (1978-1991), yielding 45 women matched by age, weight , height, and tumor size. All patients underwent Wertheim type III rad ical hysterectomy with pelvic and paraaortic lymphadenectomy. Three ra dical hysterectomies were done in the first trimester, 6 in the second trimester, and 1 in the third trimester. Time from diagnosis to treat ment of the pregnant women (P) ranged from 1 to 29 (mean 12) days. The mean estimated blood loss (P, 1055 ml; NP, 858 ml) and operative time (p, 241 min; NP, 234 min) for the two groups were similar. There was no difference in the overall transfusion rate. The overall complicatio n rate was significantly greater in the pregnant group (9 of 10 vs. 10 of 45, p = 0.00007). Two pregnant (nerve injury and cystotomy) and no nonpregnant women experienced intraoperative complications. Pregnant women had a significantly higher incidence of postoperative infection (7 of 10 vs. 9 of 45, p = 0.004). Radical hysterectomy in pregnant wom en is comparable to that in nonpregnant women in terms of operative ti me, estimated blood loss, and transfusion rate. The incidence and type of intraoperative complications require further study. There appears to be an increase in postoperative infections.