C-Sections May Increase Risk of Hysterectomy Complications: Study

New research suggests that women who undergo a c-section may face an increased risk of complications if they undergo a hysterectomy later in life, potentially resulting in the need for additional surgical procedures. 

In a study published this week in the medical journal JAMA Surgery, researchers identified a link between cesarean delivery and higher rates of hysterectomy complications later.

Using data from Danish national registries, researchers looked at more than 7,600 women who gave birth between January 1, 1993, and December 31, 2012. These women also underwent a standard hysterectomy between January 1, 1996, and Dec 31, 2012.

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Women who gave birth vaginally, then later had a hysterectomy, experienced a 4.4 percent chance of needing a second surgery within 30 days after having the first hysterectomy.

Comparatively, women who had a c-section had a 31 percent higher risk of needing a second surgery after the first hysterectomy. Women who had two or more c-sections faced a 35 percent greater risk of requiring a second surgery.

Overall, women who had a previous c-section experienced preoperative and postoperative hysterectomy complications 12 percent more of the time. They were also more likely to need a blood transfusion during the hysterectomy.

Study authors speculate this may be linked to the presence of scar tissue from the c-sections. This can cause complications in any future procedure or operation in that area because scar tissue changes the normal anatomy of the abdomen and makes it more difficult to perform surgery on those areas.

Hysterectomies, a surgery performed where the uterus is removed, are fairly common in the U.S.; they are the second most performed surgery in the country. However, they do come with some risks, like most surgeries, including excessive bleeding, damage to another organ, and infection.

Global c-section rates have increased in recent years. Despite the knowledge that a c-section can affect future deliveries and future surgeries, they are still very common and not studied often.

C-sections are the most common surgery completed in the U.S., though the number of procedures performed annually is declining. The main risks of c-section include hemorrhaging and infection. Women also face more risks when they deliver more children later on.

Research indicates certain hospital management practices can greatly affect a woman’s risk of undergoing an unnecessary c-section or requiring a lengthy hospital stay.

According to the U.S. Centers for Disease Control and Prevention, women who had a c-section, then gave birth vaginally during their next birth, were 4 times more likely to need an unplanned hysterectomy than women who never had a c-section. Women who had a c-section and require another at a later birth were 12 times more likely to need an unplanned hysterectomy.

“Women with at least one previous cesarean delivery face an increased risk of complications when undergoing a hysterectomy later in life,” wrote study authors. “The results support policies and clinical efforts to prevent cesarean deliveries that are not medically indicated.”


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