The incidence of and risk factors for complications when removing a single uterine fibroid during cesarean section: a retrospective study with use of two comparison groups

Abstract

Purpose: To determine the incidence of and risk factors for perioperative complications in women with a single uterine fibroid, who had a cesarean myomectomy (CM).Methods: This was a retrospective study of women who had a CM between 2015–2016. They were compared versus women who had a cesarean section (CS) alone and nonpregnant women who had a laparotomic myomectomy (LM).Results: We identified 44 CM women, 51 CS patients, and 44 LM women. Those with a CM in most cases had subserosal at the anterior uterine wall and near the lower uterine segment (LUS), as most frequent fibroids; moreover, they had, on average, 18 min longer surgery duration versus CS alone. CM did not affect the Apgar scores and the incidence of minor and major complications was 36.4% and 29.5%, with the most frequent being postoperative anemia (36.4%) and intraoperative hemorrhage (29.5%). No significant differences were reported on both minor and major complications in the three groups. The following variables were found to be significant predictors in univariate logistic regression analysis for the occurrence of major complications in women who had a CM: the fibroid size (OR = 1.040, 95%CI: 1.014–1.066, p = .002), and duration of surgery (OR = 1.059, 5%CI:1.012–1.108, p = .013). The fibroid diameter cut-off was 75.0 mm (sensitivity 69.2%; specificity 90.3%), and the surgery duration was 87.5 min (sensitivity 53.8%; specificity 93.5%).Conclusion: CM appears safe, with no additional risks when compared to CS alone and LM in the women of reproductive age.