Abstract
Objective A retrospective study was performed to evaluate the safety and feasibility of cesarean myomectomy among pregnant women with uterine fibroids (UFs). Methods Upon data collection, the pregnant women with UF underwent cesarean section in the 39 hospital divided into two groups: cesarean myomectomy group, receiving cesarean section and myomectomy; cesarean group, receiving cesarean section only. Information about the type, location, and number of UFs was collected from the medical records or the prenatal ultrasound examinations. Results In the cesarean myomectomy group, the proportion of subserous UFs was significantly higher than the cesarean group (65.6% versus 49.3%, P < 0.0001). The comparison of postpartum hemorrhage, neonatal weight, fetal distress, and neonatal asphyxia showed no statistical significance. Multivariate logistic regression analysis demonstrated that birth weight ≥4000 g (OR 3.1, 95% CI:1.6–6.0) and presence of diameter > 5 cm fibroids (OR 2.2, 95%CI:1.3–4.0) were high risk factors for PPH ≥1,000 ml. Conclusions Myomectomy during cesarean section was a common procedure in mainland China. Myomectomy cesarean could be safe and feasible based on the estimation by experienced obstetricians. During the procedure, special attention should be paid to a large-sized leiomyoma ≥5cm and birth weight ≥4,000 g.
Highlights
Uterine fibroid (UF), a leiomyoma originating from the smooth muscle layer of uterus, is the most common benign tumor responsible for a major cause of morbidity in women of a reproductive age
2,565 women with UFs were included in this study
The rate of drinker of cesarean alone group was higher than the cesarean myomectomy group (P= 0.002)
Summary
Uterine fibroid (UF), a leiomyoma originating from the smooth muscle layer of uterus, is the most common benign tumor responsible for a major cause of morbidity in women of a reproductive age. Several factors have been reported as a consequence of UF, including uterine bleeding and pain, infertility, and spontaneous abortion [1,2,3]. Various obstetric implications are involved in the onset of UF such as breech presentation, preterm delivery, and placental abruption [4, 5]. Most UF patients are asymptomatic and may not need therapy. As more cases select cesarean section, more attention has been paid on whether to remove the fibroids at the time of cesarean section or not
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