Myomectomy during Caesarean Section is Likely Feasible

Abstract

Uterine leiomyoma is the most common uterine neoplasm of women. The latest statistics confirm that uterine leiomyomas are present in 20-50% women of reproductive age [1]. Indeed, they are found in up to 77% of women if the uterus is examined closely at autopsy [2]. The incidence of uterine leiomyomas in pregnancy varies from 1.6% to 10.7% according to the trimester of assessment and the size threshold [3][4][5][6], with fibroids being more frequent in women of advancing maternal age, as with other high risk obstetrical factors, there has been an increasing incidence of pregnancies complicated by uterine leiomyomas in recent years. The majority of leiomyomas are asymptomatic and might not need any therapy. However, uterine leiomyomas demonstrate their maximum growth during the reproductive period and have a definite impact on pregnancy and childbirth. Compared with normal unaffected gestations, pregnancies associated with uterine leiomyomas also result in a six fold increase in the rate of caesarean section [7]. However, the diagnosis of uterine leiomyomas during pregnancy is neither simple nor straightforward. Only 42% of large fibroids (>5 cm) and 12.5% of smaller fibroids (3-5 cm) can be found in physical examination [8]. The fibroids diagnosed by ultrasound in pregnancy are even more limited, because it is difficult to differentiate fibroids from physiologic thickening of the myometrium [9][10][11]. Qidwai et al researched 15,104 women underwent routine second trimester prenatal ultrasonography and 401 (2.7%) women were identified with at least 1 leiomyoma from 1993 to 2003 [12].Obviously, the prevalence of uterine fibroids during pregnancy is likely underestimated. Therefore, the diagnosis of uterine fibroids during pregnancy is mostly to be definite at the time of caesarean section. The adequate management of leiomyomas, previously known or incidentally identified during caesarean delivery, is not as straight forward as once thought and poses a therapeutic dilemma for obstetricians.

Tumor to Tumor Metastasis: A Case Report

“…In a series of nine, Exacoustos et al reported three cesarean hysterectomies, 5 while Pattanaik et al reported one subtotal hysterectomy out of 23 CM. 6 However, in our study, no hysterectomy was performed.…”

Cesarean section and a myomectomy of a giant atypical uterine fibroid

“…Целесообразность миомэктомии во время кесарева сечения остается предметом дискуссии [1][2][3][4]. С возрастом вероятность обнаружения миомы матки увеличивается.…”

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

“…3,4,7 The procedure itself causes an increased risk of postoperative morbidity, but new studies suggest that the myomectomy can be carried out during cesarean section in selected patients and if various factors such as uterine contractility, anatomic localization, number and diameter of myomas, and the presence of vascular structures are taken into account. [5][6][7][8][9]…”