Abstract
Objectives: To assess the safety and efficacy of myomectomy during cesarean section. Methods : The study design was a prospective multicentre study done in three tertiary care hospitals in Dhaka city. The subject were 30 pregnant women underwent elective or emergency myomectomy during cesarean section. All cesarean section myomectomy were performed by consultant. Intra-operative and post-operative complications such as change in haematocrit, length of operation, blood loss were estimated. Length of hospital stay was also recorded. Results : 50 Fibroid of various sizes (2-6cm) were removed from 30 women. Fibroid were on the anterior uterine wall with most being subserous and intramural. Four patients had one unit of whole blood transfusion in post-operative period. No hysterectomy was done at the time of cesarean section. There was no significant frequency of blood transfusion; incidence of post- operative fever and duration of operation. The mean duration of post operative hospital study was 7.3±1.2 days. Two patients subsequently became pregnant, were also underwent repeated cesarean section in the study period. Conclusion : In selected cases myomectomy during cesarean section does not appear to result in an increased risk of intrapartum or short-term postpartum morbidity if performed by an experienced practitioner. Cesarean myomectomy is a safe surgical options with no significant complications. Keywords : Cesarean section; myomectomy; uterine myoma. DOI: http://dx.doi.org/10.3329/bsmmuj.v4i2.8639 BSMMU J 2011; 4(2):102-105
Highlights
Uterine myomas are the most common type of benign tumor of female reproductive tract with an incidence ranging from 5.4 to 7.7% 1,2
10% of gravidas develop complications associated with myomas during pregnancy, such as pain, abortion, placental abruption, premature rupture of membrane (PROM), premature labor, post-partum hemorrhage and dysfunctional labor[5]
It has been suggested that cesarean myomectomy is a safe surgical modality provided that it is performed in carefully selected patients[8,9,10,11]
Summary
Uterine myomas are the most common type of benign tumor of female reproductive tract with an incidence ranging from 5.4 to 7.7% 1,2. The size of a uterine myoma is greatly increased during the fertile period. This is associated with exposure to circulating estrogen[3]. 10% of gravidas develop complications associated with myomas during pregnancy, such as pain, abortion, placental abruption, premature rupture of membrane (PROM), premature labor, post-partum hemorrhage and dysfunctional labor[5 ]. In some instances cesarean myomectomy conversion to cesarean hysterectomy is necessary due to severe bleeding[6,7]. It has been suggested that cesarean myomectomy is a safe surgical modality provided that it is performed in carefully selected patients[8,9,10,11]. Myoma is a common problem in the women of reproductive age in Correspondence: Dr Nargis Akhter, FCPS, MS., House#294, Road#19/B, New DOHS, Mohakhali, Dhaka-1206
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