Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Uterine Weight & Complications After Hysterectomy

Am J Obstet Gynecol; ePub 2018 Jun 27; Louie, et al

Uterine weight is an independent factor for post-hysterectomy complications, with abdominal hysterectomy having higher odds of any complication, compared to laparoscopic hysterectomy, a recent study found. Researchers sought to determine if there is an association between uterine weight and post-hysterectomy complications and if differences in that association exist among vaginal, laparoscopic, and abdominal approaches. Patients were compared with respect to 30-day postoperative complications and uterine weight, stratified by surgical approach. They found:

  • 27,167 patients were included in the analysis.
  • After adjusting for confounders, women with 500 g uteri were >30% more likely to have complications compared to those with uteri ≤100 g, women with 750 g uteri were nearly 60% as likely, and women with uteri ≥1000 g were >80% more likely.
  • The incidence of 30-day post-surgical complications was nearly double in the abdominal hysterectomy group compared to the laparoscopic group.
  • Larger hysterectomies can safely be performed laparoscopically.

Citation:

Louie M, Strassle PD, Moulder JK, Dizon AM, Schiff LD, Carey ET. Uterine weight and complications after abdominal, laparoscopic, and vaginal hysterectomy. [Published online ahead of print June 27, 2018]. Am J Obstet Gynecol. doi:10.1016/j.ajog.2018.06.015.

This Week's Must Reads

VTE risk for continuous cycle oral contraceptives, Li J et al. JAMA Intern Med. 2018 Oct 1. doi:10.1001/jamainternmed.2018.4251

Long-Acting Opioid Use During Delivery Hospitalizations, Obstet Gynecol; ePub 2018 Sep 7; Duffy, et al

Provider Counseling in Hormonal Contraception, Contraception; ePub 2018 Sep 15; Craig, et al

Weight Gain & Hypertensive Disorders in Pregnancy, Obstet Gynecol; ePub 2018 Sep 7; Dude, et al

Vitamin D Levels and Ovarian Reserve, Fertil Steril; 2018 Sep; Shapiro, Darmon, et al

Must Reads in Gynecology

Uterine Weight & Complications After Hysterectomy, Am J Obstet Gynecol; ePub 2018 Jun 27; Louie, et al

New Persistent Opioid Use After Hysterectomy, Am J Obstet Gynecol; ePub 2018 Jun 18; Swenson, et al

Infection Prevention After Gynecologic Procedures, Obstet Gynecol; ePub 2018 Jun; Soper, Chelmow, et al

Treatment Update for Polycystic Ovary Syndrome, Obstet Gynecol; ePub 2018 Jun; Legro, et al

Hysterectomy Performed by Very Low-Volume Surgeons, Obstet Gynecol; ePub 2018 May 7; Ruiz, et al