Pregnancy Forum - C-section And Hysterectomy

Besides heavy cancer surgery, a Cesarean Hysterectomy is one of the biggest operations an ObGyn surgeon can perform. In it a hysterectomy is performed after delivering a baby by C-section. The reason it's one of our biggest operations is because the organ being removed is just so big. The uterus, normally no bigger than a pear, is at delivery...well...as big as a baby. And it is well supplied with blood vessels that would strike fear into even a cardiovascular surgeon. There's just a lot more clamping, cutting, and tying then with a "regular" hysterectomy.

There's two to three times the blood loss than usual. There's more chance of transfusion and other complications. But a well-trained Gyn surgeon will usually have a very low complication rate when a patient is selected carefully for this operation. And there are times when a Cesarean Hysterectomy is a good idea.

If a woman desires permanent sterilization and she had indications for a hysterectomy before the current pregnancy (if there's a hysterectomy in her future), then the advantageous combining of delivery with a hysterectomy will make a second hospitalization unnecessary. A Cesarean Hysterectomy will be the two-birds-with-one-stone solution. One hospitalization, one anesthetic, one price (albeit more than a straightforward C-section)--all are considerations that make sense.

Indications for hysterectomy can include pre-cancerous conditions of the cervix, pre-pregnancy heavy periods interfering with work or lifestyle, pre-pregnancy relaxation of the uterus to a point wherein pain begins to cause severe limitations on sex, recreation, or just being vertical.

Sometimes an emergency Cesarean Hysterectomy needs to be done. If massive bleeding at the time of a C-section cannont be controlled, the ultimate solution may be removing the organ that's doing all of the bleeding before the patient dies! Also, with previous C-sections, a patient may present at surgery with a rupture of the old incion site on her uterus to such an extent that it cannot be repaired with any degree of safety toward future pregnancies.

Strangely enough, recuperation from a Cesarean Hysterectomy is easier than from a C-section. This is because there's a lot of discomfort originating from the uterus contracting against that incision used to get the baby out. But with a hysterectomy, there's no uterus contracting. This large organ, normally somewhat flopping around to twang all those sore spots in the abdomen, is missing. And so is a lot of the pain.

Like anything in medicine, when it works well, it works great. And when it doesn't, things can be very bad indeed. Unless one's caught in an emergency situation, patient selection under controlled circumstances can make this bigger operation fairly straightforward.

taken from http://gynob.com/hyst.htm