When it is oportune to avoid cesarean myomectomy? An analysis of possible factors influencing duration of treatment in the intensive care unit

Abstract

Background: Cesarean myomectomy (CM) is a controversial issue, even relatively contraindicated in obstetric practice. Recent reports showed that CM is not associated with increased morbidity, but those are lacking the data about risks of intensive care unit (ICU) treatment. Aim: The authors evaluated the factors affecting the duration of ICU treatment in patients after CM. Material and Methods: The study included 57 women who underwent CM and were postoperatively admitted and treated in ICU. Correlation analysis was used to estimate the effect of various parameters on the duration of ICU treatment. Results: There was a highly significant correlation between duration of ICU treatment and number of postoperative transfusions (p=0.001), duration of surgery (p=0.007), intraoprative hemorrhage (p=0.008) and myoma diameter (p=0.009). Duration of ICU treatment was also correlated with gestational age, hypertensive syndrome in pregnancy, preoperative hematocrit and hemoglobin values, number of intraoperative transfusions, postoperative hemorrhage and repeated myomectomy. Conclusions: In our report, longer ICU tretment was required in cases of perioperative hemorrhage, prolonged surgeries and those requiring perioperative transfusion. Patients who have had previous myomectomy, with lower preoperative hemoglobine and hematocrit vaues and bigger myomas are at risk of prolonged ICU treatment.