Having a caesarean section raises the risk of complications if a future hysterectomy is needed, according to a new Danish analysis.
Women who have had a caesarean tend to have a greater need for a future hysterectomy, according to the researchers. Dr Sofie Lindquist of Aalborg University, Denmark and colleagues looked at the rate of complications in these women.
They took figures from Danish nationwide registers on births between 1993 and 2012, and underwent hysterectomies (for non-cancer reasons) between 1996 and 2012. Details on 7,685 women were included.
Those who had one caesarean delivery had a 31% increased risk of reoperation after a hysterectomy within a month, and those with two or more caesareans had a 35% increased risk of reoperation, compared with women who had vaginal deliveries. The research team also found a higher rate of surgical complications in women with a previous caesarean, and a higher rate of blood transfusion among women having two or more caesareans.
Full results appeared in JAMA Surgery. The authors write: "The high prevalence of hysterectomy later in life makes this procedure a useful proxy for investigating long-term surgical complications associated with previous caesarean delivery.
"A prior caesarean delivery may be related to lower urinary tract injuries, increased intraoperative and postoperative blood transfusion, and readmission within 30 days of a hysterectomy."
They add: "The increased risk of reoperation and complications related to hysterectomy later in life supports policies and clinical efforts to prevent caesarean deliveries that are not medically indicated."
Lindquist, S. A. I.et al. Association of Previous Cesarean Delivery With Surgical Complications After a Hysterectomy Later in Life. JAMA Surgery 9 August 2017; doi:10.1001/jamasurg.2017.2825
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