Outcome of Cesarean Myomectomy: Is it a Safe Procedure?

Abstract

Objective Myomectomy performed during cesarean section is still controversial because of the potential for associated complications, especially with large myomas. Many obstetricians avoid performing cesarean myomectomy procedures because of the risk of uncontrollable hemorrhage. However, the prevalence of pregnant women with myomas is increasing, leading to an increase in the likelihood that physicians will encounter this issue. The aim of this study was to compare outcomes and complications of patients who either had or did not have cesarean myomectomy. Method A total of 361 patients were evaluated in this retrospective study. Patients who had cesarean section with myomectomy and patients had cesarean section without myomectomy were compared with regard to demographics, drop in hemoglobin levels, complications, blood transfusion rates and duration of operation. These parameters were also compared when the diameter of the myoma was larger than 5 cm. Values of p < 0.01 and p < 0.05 were considered statistically significant. Results While maternal age and gravidity were similar in both groups (p > 0.05), the mean myoma diameter was smaller and the duration of operation was longer in the group who underwent cesarean myomectomy (p < 0.05). The reduction in hemoglobin level, rate of complications, and number of transfusions were similar in both groups (p > 0.05). Conclusion This study shows that myomectomy during cesarean section does not increase complications or transfusion rates and appears to be a safe procedure.

Myomectomy during cesarean section: is it a safe procedure?

“…In that study, they also evaluated 66 C/S myomectomy patients having myomas of 5 cm or more in diameter along with 31 non-myomectomy patients and reported that no differences were found between the C/S myomectomy group and the non-myomectomy group in terms of lowered hemoglobin levels, necessary blood transfusions or operation-related complication rates. [21] We achieved similar results in our study.…”

Outcomes of Myomectomy at the Time of Cesarean Section among Pregnant Women with Uterine Fibroids: A Retrospective Cohort Study

“…Conventionally, myomectomy is not recommended for those undergoing cesarean section as it may induce perioperative complications, especially the excessive hemorrhage that may involve an emergency hysterectomy [ 9 – 11 ]. In recent years, many studies indicated that myomectomy during cesarean delivery was safe and feasible [ 12 – 14 ]. We aim to investigate the safety and feasibility of cesarean myomectomy among pregnant women with uterine fibroids through analyzing the obstetric outcomes.…”

“…In a previous study [ 14 ], Kaymake et al reported no significant increase of bleeding risk and frequency of blood transfusion between the patients underwent cesarean myomectomy or cesarean section alone. In addition, Topcu et al [ 15 ] revealed the outcome variables (e.g., frequency of postoperative fever and mean duration of hospital stay) showed no significant difference between the cesarean myomectomy group and cesarean group.…”

Making caesarean myomectomy safe and feasible: a 12 year single center experience

“…Senturk et al also found control of bleeding by suturing the myoma bed and use of oxytocin but in some cases still uterine atony and bleeding occurred requiring hypogastric artery ligation. 7 We had used prophylactic B-Lynch sutures in all our patients. No atonic PPH occurred in any patient and none of them required hysterectomy.…”