Complications during cesarean delivery in a patient with two previous myomectomies

Abstract

Myomas are associted with numerous pregnancy-related maternal and fetal complications, including high rate of cesarean deliveries. We present a woman with huge posterior myoma who had two previous myomectomies. During the cesarean section, the anatomy was found to be grossly distorted. Thus it was necessary to make an inverted T-incision on the uterus, which facilitated delivery of the fetus. The patients postoperative recovery was uneventful. This case illustrates the difficulties that may arise during cesarean section in the presence of uterine myomas in women with previous myomectomies. Clinicians should be prepared to manage those difficulties with inverted T-incision in order to prevent fetal injuries. Such operations should be performed by an experienced obstetrician.