The Utility of Postoperative Hemoglobin Testing for Benign Hysterectomy and Myomectomy

Study Objective To evaluate the incidence of a significant decrease in hemoglobin (Hgb), defined as ≥ 2g/dL, on routine labs postoperative day 1 (POD1) after benign hysterectomy and myomectomy and compare subsequent interventions in those with and without a significant decrease. Design This is a retrospective cohort study. Operative notes and clinical encounters up to six weeks after surgery were reviewed. Setting N/A. Patients or Participants Those undergoing laparoscopic, robotic-assisted, abdominal, or vaginal hysterectomy or myomectomy from 1/2014- 1/2019 at a tertiary referral center. Patients with known malignancy, hysteroscopic or concomitant cesarean surgeries were excluded. Interventions N/A. Measurements and Main Results Table 1 includes patient characteristics. Descriptive statistics compared outcomes between those with and without Hgb decrease ≥ 2 g/dL on POD1. 1120 patients were included. 984 had pre- and post-operative Hgb, 41% with a significant decrease. A decrease was least common with the laparoscopic route. Postoperative interventions were not significantly different between groups. (Table 2) However, those with a significant Hgb decrease more frequently had an additional CBC drawn. When comparing those with routine postoperative labs drawn (n=1017) vs. without (n=103) there were no differences in interventions other than additional lab draws and length of stay. Conclusion There is limited utility in measuring postoperative hemoglobin routinely after benign hysterectomy and myomectomy given no difference in interventions performed between groups.