Caesarean Myomectomy among Patients Undergoing Lower Segment Caesarean Section in a Tertiary Care Center

Abstract

Pregnancy with uterine myoma increases the risk of abortion, fetal malpresentation, placenta previa, postpartum hemorrhage, hysterectomy and risk to neonate and mother. Caesarian myomectomy is a safe and cost-effective procedure especially when performed by an experienced surgeon only in selected cases. Here, we present our experiences of cesarean myomectomy on ten patients presenting to our center in a period of one year. The most common indications were breech presentation and previous cesarean section. The most common site was anterior, except one which was posterior and the common type is intramural. Despite prophylactic measures, two cases had a postpartum hemorrhage of 2000ml and 700ml, respectively and one even received a blood transfusion. No cases of hysterectomy, neonatal morbidity and mortality were noted in these cases. In our experience, cesarean myomectomy in uterine fibroids has been a safe procedure with limited intraoperative and postoperative complications.

Reflections on Postpartum Hysterectomy as a Possible Complication of Cesarean Myomectomy: A Long Debate

“…A case series on 10 cases of CM with single anterior-wall fibroids indicated only two cases of PPH, one of which involved severe blood loss of over 2000 mL, requiring a blood transfusion and a uterine tourniquet placement as a hemostatic measure [34].…”