Planned cesarean hysterectomy: A preferred alternative to separate operations

OBJECTIVE: The aim of this study was to evaluate our institutional experien ce with planned cesarean hysterectomy. STUDY DESIGN: In this retrospective case-control investigation of a 16-year experience, 100 pregnant women who underwent planned cesarean hysterectomy were compared with 37 patients who underwent cesarean delivery followed by a hysterectomy performed within 6 months. RESULTS: Women undergoing planned cesarean hysterectomy did not have any de monstrable increase in intraoperative or postoperative complications when c ompared with the cesarean delivery plus later hysterectomy group. Primarily as a result of significantly reduced hospital stay and shorter total opera tive time, there was a significant financial advantage associated with a si ngle planned cesarean hysterectomy with respect to separate operations. CONCLUSIONS: A policy to undertake planned cesarean hysterectomy for carefu lly selected patients appeared to produce advantages without increasing ris ks for these patients. Secondarily, it provided resident physicians the opp ortunity to learn the operation with supervision and under controlled circu mstances.