We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure coreplatform@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
In the late nineteenth and early twentieth century it was taught that vaginal hysterectomy could not be performed if the uterus was enlarged, but uterine size was never quantified. Other suggested contraindications included a ‘narrow vagina’ (pubic arch < 90°) and a diminished bituberous diameter (< 8.0 cm). The bituberous diameter represents the distance between the ischial tuberosities (or sitting bones) which are easily palpated when the patient is in the dorsal lithotomy position. Nulliparity and “a uterus that was too high or did not come down” were also considered as contraindications to the vaginal approach, as were “intra-abdominal conditions” such as endometriosis, adhesions, previous pelvic surgery, previous cesarean section, and chronic pelvic pain.
Hysterectomy became the second most common operation performed in the USA in the middle twentieth century, but the complications related to this operation were not re-evaluated until 1982. The Collaborative Review of Sterilization (CREST) from the CDC studied the complications of abdominal and vaginal hysterectomy. For operative indications that could have been performed by either route, abdominal hysterectomy had a complication rate twice that of the vaginal approach.
Recommend this
Email your librarian or administrator to recommend adding this to your organisation's collection.