Myomectomy at the Time of Cesarean Section: A Prospective Multicentre Study

Akhter, Nargis; Begum, Firoza; Begum, Nurjahan; Chowdhury, Saleha Begum; Fatema, Nilufar; Amin, Selina Akhter; Hasan, Zahidul; Rahman, Fazlur; Hossain, Anwer

doi:10.3329/bsmmuj.v4i2.8639

Cited by 3 publications

(5 citation statements)

References 12 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, none of the patients had hysterectomy on account of haemorrhage but Hassan et al in their series reported three hysterectomies that undergone caesarean myomectomy. 20 The average time taken to perform caesarean myomectomy was 53 mins which was comparable to the results of Ahikari et al & Nargis Akhter et al 4,12 In our study group 9.52% of the patients required blood transfusion and these patients had their caesarean section on account of placenta praevia. This percentage is low compared with 20% of the patients that needed blood transfusion in the series that did routine caesarean myomectomy for all anterior fibroid.…”

Section: Discussionsupporting

confidence: 89%

“…11 More recently; some authors have advocated routine removal of all anterior wall uterine fibroid during caesarean section. 10 The mean age in our study group was 31.7 years with majority (66.66%) of the patients under thirty five years which was similar to the result of Nargis Akhter et al 12 The patients were mainly primigrivida (71.43%). Adesiyun et al reported 22 cases of caesarean myomectomy where the mean age was 31.5 years with 72.8% of the patients under thirty five years and 72.7% of the patients were primigravida, which were more or less similar to our study.…”

Section: Discussionsupporting

confidence: 87%

See 1 more Smart Citation

Safety of routine caesarean myomectomy

Biswas

Fatema

Akhter

2014

Bangladesh med. j. Khulna

View full text Add to dashboard Cite

The study was done to evaluate the safety and clinical outcome of routine caesarean myomectomy. This was a prospective descriptive study done in Obstetrics & Gynaecology department of Khulna Medical College Hospital & Sadar Hospital, Satkhira and two private clinics in Khulna city. Over a period of 4 years from July, 2009 to June, 2013, twenty one cases of caesarean myomectomy were presented. Our technique comprised of infiltration of vasoconstritive agent (ceprecin) before nucleation of myoma, myoma cavity accomplished by using "U" stitches of myometrial closure, routine use of oxytocin in post operative period for 24 hours. It was seen in this study that the mean age of the patients was 31.7 years and most of the cases (71.43%) were primigravida. Caesarean myomectomy done in term pregnancy was 85.71%. Elective surgery was done in 85.71% and emergency surgery was 14.29%. Two leading indications for caesarean section were malpresentation/ abnormal lie in 42.85% and uterine fibroid in 23.81%. Fibroid in lower uterine segment for selective myomectomy was 61.90%. Maximum (21,65.63%) fibroids were removed from the lower uterine segment and 22 (68.75%) of the fibroids were between 5 cms to 10 cms in size. The morbidities encountered were anaemia with blood transfusion in 2 (9.52%) and post partum pyrexia in 1 (4.76%) patients. No woman needed hysterectomy. Caesarean myomectomy may be done routinely by experienced surgeon and routine use of vasopressin into myoma capsule to combat uterine atony & severe bleeding. DOI: http://dx.doi.org/10.3329/bmjk.v46i1-2.18232 Bang Med J (Khulna) 2013; 46 : 7-11

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 87%

Safety of routine caesarean myomectomy

Biswas

Fatema

Akhter

2014

Bangladesh med. j. Khulna

View full text Add to dashboard Cite

show abstract

“…Generally most of the obstetricians do not suggest myomectomy during caesarean delivery due to increased chance of severe haemorrhage which may lead to hysterectomy 1 . And it is a common practice to do interval myomectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Uterine myoma is the commonest tumour of female genital tract 1,2 . Though myoma has special association with infertility (25-30%) 3 , pregnancy with myoma or myoma complicating pregnancy is not so uncommon.…”

Section: Introductionmentioning

confidence: 99%

Caesarean Myomectomy is No Longer a Dreaded Job: a Case Control Study in Multiple Specialized Centre

Zeba

Das

Fatima³

et al. 2013

Faridpur Med Coll J

View full text Add to dashboard Cite

:Removal of uterine myoma during caesarean section (CS) is not commonly done due to fear of severe haemorrhage which may lead to hysterectomy. Contradicting the previous belief many studies have been showing that myomectomy during caesarean section is a safe procedure without significant increase of risk. The objective of this study is to analyze the safety and clinical outcome of caesarean myomectomy. This is a prospective study carried out in different hospitals of Faridpur district, Bangladesh from 01.01.10 up to 31.12.12. Total 16 (study group) patients had undergone caesarean myomectomy. Operation time, peroperative blood loss, post operative complications and length of hospital staying was compared with that of 32 women (control group) with caesarean section alone. The result shows that peroperative blood loss was average 350±100 ml in study group which is 50 ml more than control group. Operation time was 20 minutes more and length of hospital staying was 1 day more than control group. There was no post partum haemorrhage, no hysterectomy was done at the time of CS and there was no maternal or perinatal mortality. So, caesarean myomectomy is safe and convenient to patient and cost effective without increasing any extra risk.

show abstract

“…In the current study,subserosal myomas had the heighest incidence (53.3%) as reported by other authors. 24 In general, most obestricians have been instructed not to perform uterine myomectomy during cesarean section,with the exception of pedunculated myomas because of risk of massive hemorrhage, and the possibility of hysterectomy. However, if the uterine myomas are not removed, the possibility of re-operation due to complications arising from myomas and the influence on future pregnancies persist.…”

Section: Discussionmentioning

confidence: 99%

Myomectomy at Cesarean Section: Descriptive Multicentre Study

Begum

Hossain

Nahar³

2011

TAJ: J of Teachers Assoc

View full text Add to dashboard Cite

Background: In the tropics, leiomyoma are commonly encountered in women of the reproductive age group, although they are mostly asymptomatic. Surgery for uterine fibroid at caesarean section has remained controversial. Objective: The study design was a prospective multicentre study to analyse the clinical outcome of women that had selective caesarean myomectomy in a medical college and private hospitals in Dinajpur,Bangladesh. Method: Thirty women that had selective myomectomy at caesarean section between January 2004 and February 2012 were analysed. Results: The patients mean age was 32.6 years with age range of 21–39 years. Of the 30 patients, 21 (70 %) were Primigravida, 27 (90%) of the patients had caesarean section at term, 2 (6.6%) and 1 (3.3%) of the patients were preterm and post term respectively. A significant number of the patients 28 (93.4%) had elective caesarean section and the remaining 2 (6.6%) patients had emergency caesarean section. The 3 leading indications for caesarean section among the patients were malpresentation/abnormal lie 23%, uterine fibroids 26.6%, and a previous caesarean section with complication in 20% of the patients. Indications for myomectomy at caesarean section were fibroid in lower uterine segment in 18 (60%) patients, pedunculated uterine fibroid in 8(26.6%) patients and anterior subserous fibroid in 4 (13.3%) patients. Intraopertively in the 30 patients, 15 (50%) had fibroid(s) removed only in the lower uterine segment; while 7 (23.3%) patients had removed in the upper uterine segment and 8(26.6%) had both upper and lower uterine segments. A total of 75 fibroids were removed in the 30 patients, of which 40 (53.3%) were subserous/pedunculated, 25 (33.3%) intramural and 10 (13.3%) were submucous. Of the75 fibroids, 51 (68%) were between 6 to 10 cm size. Sixteen (53.3%) of the 30 patients lost between 751 to 1000 ml of blood intraoperatively with an average of 860 ml of blood loss. Five (16.6%) ofthe 30 patients had blood transfusion due to anaemia. Other complications encountered were puerperal pyrexia and sepsis in 2 (6.6%) patients. There was no maternal and perinatal mortality. Conclusion: Selection of patients for caesarean myomectomy reduces blood loss, anaemia and other complications. TAJ 2011; 24(1): 38-42

show abstract

Myomectomy at the Time of Cesarean Section: A Prospective Multicentre Study

Cited by 3 publications

References 12 publications

Safety of routine caesarean myomectomy

Safety of routine caesarean myomectomy

Caesarean Myomectomy is No Longer a Dreaded Job: a Case Control Study in Multiple Specialized Centre

Myomectomy at Cesarean Section: Descriptive Multicentre Study

Contact Info

Product

Resources

About