UTERINE SIZE AND RISK OF COMPLICATIONS AMONG WOMEN UNDERGOING ABDOMINAL HYSTERECTOMY FOR LEIOMYOMAS

Objective: To measure the influence of uterine size on the risk of ope rative complications among women undergoing abdominal hysterectomy for uterine leiomyomas. Methods: Four hundred forty-six women undergoing abdominal hysterectomy for pathologically confirmed leiomyomas were an alyzed using data from a previously reported prospective cohort study. We compared the risk of operative complications among women with uter ine weights less than 250 g, 251-500 g, and greater than 500 g. Logist ic regression was used to estimate the independent effect of uterine s ize on the probability of operative complications. Results: The risk o f 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 gr and greater than 500 g, respectively, required transfusion (P for tre nd < .05). After adjustment for race, previous surgery, preoperative w eight, 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 l oss greater than 500 mt (OR 2.5, 95% CI 1.5-4.2), vaginal cuff celluli tis (OR 2.8, 95% CI 1.3-6.2), and at least one of a number of operativ e complications (OR 1.6, 95% CI 1.0-4.0). Conclusion: Women with leiom yomas whose uterine weight exceeds 500 g have an increased risk of com plications from abdominal hysterectomy.