Caesarean myomectomy dilemma: Do or not to do?

Document Type : Original Article

Authors

1 Lecturer of Gynecology and Obstetrics, Faculty of Medicine, Zagazig University

2 Pathology Department, Faculty of Medicine, Zagazig University

3 Department of Obstetrics and Gynecology, Faculty of Medicine –Zagazig University, Zagazig, Egypt

Abstract

Objective: Aim of the study was to clarify the risk–benefit ratio of cesarean myomectomy
Materials and methods: The study group included twenty pregnant women with uterine myoma who were indicated for caesarean section. Myomectomy (serosal or endometrial) was done during caesarean section. Main outcome measures were: difficulty of myomectomy and caesarean section, time needed for operation, intraoperative bleeding, need for blood transfusion, postoperative complications and duration of hospital stay.
Results: During the study period, a total 20 cases of caesarean myomectomy were done. Seventeen(85%) women were of 23 -30 years of age. Fifteen(75%) women were primiparous. Myomas were diagnosed in sixteen(80%) women before pregnancy. Sixteen(80%) women had single myoma. Myoma was located in the body of the uterus in fourteen(70%) of cases. Four(20%) women had subserous myomas, twelve(60%) had subserous –intramural myomas and four(20%) had intramural-submucous myomas. In three(15%) women, the diameter of the myoma was more than 10 cm. In the remaining seventeen (85%) women, it varied from(5-10)cm. Myomectomies were successful without need of blood transfusion in all cases. The average change in pre and post-operative hemoglobin was found to be 1.08 ± 0.26 g/dL. Operative time was

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