Maternal complications following caesarean myomectomy and caesarean alone-an observational comparative study

Abstract

Uterine leiomyoma is the commonest tumour of female genital tract. Earlier myomectomy at caesarean sections was generally avoided due to fear of intractable haemorrhage and atonicity leading to subsequent hysterectomy and future fertility issues. The aim of this study is to compare the intra-operative and post-operative complications following caesarean myomectomy and caesarean section alone in antenatal patients with myomas. A hospital based observational comparative study was peformed on 38 antenatal woman with myomas, include 19 antenatal patients with myomas who were posted for caesarean myomectomy compared with age matched 19 antenatal women who were posted for caesarean alone , were selected for the study in the department of obstetrics and gynecology. In the present study patients mean age was of 30.8+5 yearsand 30.8+5 years respectively for caesarean myomectomy and caesarean group. Out of the 38 patients 15 patients were primipara and 13 patients were multipara. The duration of surgery for caesarean myomectomy was 65 ± 12.9minutes compared to 47.4 +4.2 minutes in caesarean only group. Out of the 38 patients mean and standard deviation of hemoglobin fall during surgery in caesarean myomectomy was 1.1+0.7gm/dl when compared to 0.7+0.2gm/dl in caesarean group. And 2 patients needed blood transfusions post-operatively in caesarean myomectomy compared one patient in caesarean group. The hospital stay in hours in caesarean myomectomy was 126.3±10.9 hours and 121.3±5.5 hours in caesarean group. None of them ended on obstetric hysterectomy. In this study, No significant difference was observed in haemoglobin change, incidence of intra-operative complications and length of hospital stay, in the caesarean myomectomy group as compared to other post caesarean group. The possibility of performing myomectomy during caesarean section has become a safe procedure with experienced surgeons and anaesthetic facilities