Effect of Cesarean Hysterectomy with Ovarian Preservation on Ovarian Reserve: Retrospective cross section study (Pilot Study)

Abstract

Our aim of the study was evaluate the effect of cesarean hysterectomy with ovarian preservation on ovarian function in premenopausal women and occurrence of early menopause. This retrospective cross sectional study was conducted at Ain Sham University Maternal Hospital on 105 patients with cesarean hysterectomy with ovarian preservation due to obstetric causes (as placenta accrete, atony, abruptio placentae and uterine rupture, …...), during the last five years (from 2015 to 2020). All patients included in the study were subjected to informed consent, detailed history taking and full examination measuring level of FSH in serum and further more TV-US for Doppler assessment to measure PI & RI of ovarian artery was done. Descriptive statistics was done including mean ± SD, range frequency and percentage, Chi-square (X2) test was used to compare proportions between qualitative parameters and odds ratio were computed to assess the overall association between each possible risk factors of occurrence of menopause significant level is set at 0.05. There was statistically significant difference between levels of ovarian functions according to age during taking blood sample and FSH level. There was statistically significant difference between poor ovarian function and early ovarian failure according to menopausal symptoms (dysparunia & vaginal dryness), VMS (hot flashes & night sweating), menopausal complications (osteoporosis) and history of menstrual irregularity related to FSH level, In this study there was statistically significant variation in FSH level in poor ovarian function relative to smoking. There was no statistically significant differance between poor ovarian function and early ovarian failure according to age during operation, body mass index, total deliveries, number of CS and cause of CS hysterectomy. In this study there was no significant Doppler affection or decrease in ovarian blood flow (RI & PI of ovarian artery). This study CS hysterectomy as a procedure irrelevant of age has no significance on ovarian reserve and FSH levels (p value 0.185), as there are many factors influencing this, such as age, smoking and history of menstrual irregularities.