Previous cesarean section - A contraindication to vaginal hysterectomy?

OBJECTIVE: To compare surgical outcomes of vaginal hysterectomy between wom en who have had one or more cesarean deliveries and those who have not. STUDY DESIGN: A retrospective, chart review study was performed on women un dergoing vaginal hysterectomy during a four-year period. Of 275 women who m et the study criteria, 104 had a history of previous cesarean deliveries, a nd 171 did not. The groups were compared for indications for surgery, opera tive time, length of hospitalization and surgical complications. RESULTS: Previous cesarean delivery did not affect hemoglobin loss, hospita l stay or operative time among women undergoing vaginal hysterectomy. The c omplication rate (either operative or postoperative) was 12.3% among women without a history of cesarean section, 6.8% among those with one, 3.7% amon g those with two and 11.1% among those with three or more (chi (2) = 2.8, P = .4). The odds for surgical complications were not significantly differen t between women with one or more prior cesarean deliveries as compared to t hose without after adjustment for possible confounders. CONCLUSION: Surgical complications with vaginal hysterectomy do not appear to be higher among women with a prior cesarean section as compared to those without a history of such operation.