Comparison of operative risks associated with radical hysterectomy in pregnant and nonpregnant women

OBJECTIVE: To compare the operative data and complications of radical hysterectomy performed on pregnant women versus nonpregnant women. STUDY DESIGN: Following institutional review board approval, we reviewed our surgical databases to identify pregnant women who had undergone a radical hysterectomy for cervical carcinoma from 1992-2005 (n=7). A non-pregnant control group (n=35) of women undergoing radical hysterectomy during the study interval were identified and matched for age, year of surgery, and surgeon. Pertinent operative and outcome data were abstracted and compared RESULTS: Of the 7 women who had undergone a radical hysterectomy during pregnancy, 4 had a cesarean radical hysterectomy at a mean gestational age of 35.4 weeks (range, 32.3-38 weeks) and 3 had a radical hysterectomy with a previable fetus in situ at a mean gestational age of 14.2 weeks. Demographics were similar between groups. Transfusion rates were significantly higher among pregnant women (57%) as compared to non-pregnant controls (9%) (p =0.0009). The overall incidence of operative complications was similar between the pregnant women (43%) and nonpregnant controls (40%) (p = NS). CONCLUSION: Radical hysterectomy performed in pregnant women was associated with higher blood loss and increased need for transfusion as compared to non-pregnant controls. No differences were observed in regards to other operative surgical complications between the two groups.