Safety Of Cesarean Myomectomy Research Articles

Risk factors based on myoma characteristics for predicting postoperative complications following cesarean myomectomy.

To evaluate the influence of myoma characteristics on cesarean myomectomy and to demonstrate its additional advantages. Retrospective data were collected from 292 women with myomas who had undergone cesarean section at Kangnam Sacred Heart Hospital between 2007 and 2019. We performed subgroup analysis according to the type, weight, number, and size of myomas. Preoperative and postoperative hemoglobin levels, operative time, estimated blood loss, length of hospital stay, incidence of transfusion, uterine artery embolization, ligation, hysterectomy, and postoperative complications were compared among subgroups. There were 119 patients who had cesarean myomectomy and 173 who had cesarean section only. An increase in postoperative hospitalization and operation time was observed in the cesarean myomectomy group compared to that in the caesarean section only group (mean difference, 0.7 days, p = 0.01, 13.5 minutes, p <0.001). Estimated blood loss, hemoglobin differences, and transfusion rates were higher in the cesarean myomectomy than in the cesarean section only group. There were no differences in postoperative complications (fever, bladder injury, and ileus) between the two groups. No hysterectomy cases were reported in the cesarean myomectomy group. In subgroup analysis, the larger and heavier the myoma, the higher the risk of bleeding that led to transfusion. Estimated blood loss, differences in hemoglobin, and transfusion rate increased depending on myoma size and weight. A significant increase in postoperative hospitalization was observed in women with larger and heavier myomas. However, there was no statistical difference among the three types of myomas. In cesarean myomectomy, larger (≥ 10 cm), and heavier myomas (≥ 500 g), were associated with postoperative outcomes, but not the number or type of myoma. The safety of cesarean myomectomy is not inferior to that of caesarean section only, considering its positive effects such as gynecological symptom relief and avoidance of the next surgery.

Success and Safety of Cesarean Myomectomy in Women with Single Uterine Myoma

Success and Safety of Cesarean Myomectomy in Women with Single Uterine Myoma

Cesarean Myomectomy: Experience at a Tertiary-Care Center

Abstract Objectives: The aim of this study was to evaluate the outcomes and procedural safety of cesarean myomectomy (CM). Materials and Methods: In this retrospective cohort study 55 cases of CM—5...

Safety of cesarean myomectomy in women with single anterior wall and lower uterine segment myomas

Objective: Cesarean myomectomy (CM) is a safe procedure in selected cases. Nevertheless, literature lacks clear guidelines on patient selection. We aimed to evaluate CM safety in patients with single anterior wall and lower uterine segment (LUS) myomas.Methods: The authors selected pregnants at term, scheduled for CSs, with single anterior wall or LUS myomas. All their clinical, demographic, obstetric, and surgical parameters were recorded.Results: Thirty-six women had a CM (study group), and 17 had a CS without myoma removal (control group). No significant differences were detected in the socio-demographic and clinical findings between the groups. The average size of myomas in the study and control group (p = .873), was 55.44 mm and 47.25 mm, respectively. The average surgery duration was 62.5 min in the study and 53.82 in the control group (p = .058). Intraoperative hemorrhage was more frequent in the study group (p = .045). Nevertheless, neither the number nor the volume of intraoperative transfusions was significantly different. None of the major CM complications were recorded, and the duration of hospitalization was similar in both groups.Conclusions: CM in patients with single anterior wall and LUS myomas does not cause increased perioperative morbidity, and, therefore, can be considered safe in such cases.

Myomectomy at Cesarean Delivery in Aba, Southeastern Nigeria

INTRODUCTION: Myomectomy during cesarean delivery is usually avoided because of the risk of intractable hemorrhage. This study was undertaken to compare the efficacy and safety of cesarean myomectomy with a control group with uterine fibroids who had cesarean delivery without myomectomy. METHODS: A prospective clinical trial of cesarean myomectomy compared with cesarean delivery without myomectomy in women with uterine fibroids in pregnancy was carried out in Nigerian Christian Hospital, Aba, between March 2004 and March 2010. Thirty-four patients with uterine fibroids in pregnancy and who had cesarean delivery and myomectomy for various indications were selected. Thirty patients who also had uterine fibroids in pregnancy and had cesarean delivery alone were selected as control participants. RESULTS: The estimated blood loss, postoperative packed cell volume, and the need for blood transfusion and operation time were significantly higher in the cesarean myomectomy group when compared with those in the control group. Among patients in the study group, the need for blood transfusion and operation time were significantly higher in those who had greater than 10 myomas when compared with those who had less than 10 myomas. There was no significant difference in the incidence of postoperative fever and duration of hospital stay between the cesarean myomectomy patients and those in the control group. CONCLUSION: This study adds to growing body of evidence demonstrating the safety and efficacy of cesarean myomectomy in selected patients but it also shows that it should be carried out with caution and adequate cross matched blood, especially in patients with multiple fibroids.