Myomectomy During Caesarean Section: Seven Years’ Experience

Abstract

Introduction: The incidence of myomas during pregnancy is reported as 1.6-10.7% depending on gestational age. Increased rates of Caesarean Section (CS) together with advanced maternal age bring the decision for caesarean myomectomy (myomectomy during caesarean section) into question. Aim: To compare the obstetric features and clinical outcomes of pregnant women with uterine leiomyoma who had myomectomy together with caesarean section to those who had caesarean section only. Materials and Methods: A retrospective study was performed on a total of 50 pregnant women with myoma that underwent caesarean section in the Obstetrics and Gynaecology Department of Trakya University Medical Faculty between 2007 and 2014. Obstetric history, operative details and type, size and location of leiomyoma were noted and compared. Data were analysed using the IBM Statistical Package for Social Sciences version 17.0 (SPSS Inc., Chicago, IL, USA). Parametric tests were applied to data with normal distribution and non-parametric tests were applied to data without normal distribution. Results: Two groups displayed similar features in terms of age, parity, gestational weeks, type and location of leiomyomas. Notably, average size of leiomyomas was larger (p=0.03) and duration of operation was significantly longer in patients that underwent caesarean myomectomy (72.69±26.73 minutes vs. 56.25±6.64 minutes) (p=0.003). Duration of hospitalisation and preoperative/postoperative values for haemoglobin and hematocrit levels did not show any clinically significant difference (p >0.05). Conclusion: Our results demonstrate that caesarean myomectomy is a safe and effective procedure in especially cases with large uterine leiomyomas.

Keywords

• Pregnancy
• Uterine leiomyoma
• Uterine myomectomy