Myomectomy during Caesarean Section: Is it Effective and Safe Procedure?

Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

2 Department of Physiology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt.

Abstract

Background: The existence of known or incidental leiomyomas throughout pregnancy and the management of individuals with myomas in conjunction with pregnancy are two of the most contentious subjects in obstetrics and gynecology. Many obstetricians face a formidable task owing to the wide range of knowledge, skills, facilities, and resources available in different geographic locations.
The Aim of The Work: The current study designed to examine the efficacy and safety of myomectomy during cesarean section.
Patients and Methods: 71 individuals with single or multiple myomas were scheduled for elective or selective caesarean section were included in this prospective observational study. Main outcome measures were blood transfusion, postoperative ecbolic usage, time required for surgery, problems during surgery, re-laparotomy to control bleeding or to perform hysterectomies, postoperative complications, and length of stay following surgery.
Results: The average blood loss during surgery was 518.3+80.9 mm3 [not including bleeding from the CS incision], and there was no significant bleeding after surgery. The preoperative mean hemoglobin level was 10.35+0.7, while the postoperative value was 10.08 + 0.9 g/dl. There were no postoperative complications for 84.4%, and 82.2% of myomas were in the uterine body; the most prevalent type was intramural [75.6%]. 66.0% of women had a myoma that was no larger than 5 centimeters. A caesarean myomectomy was accomplished in 80% of instances in less than an hour. After the birth of the infant, in 93.3 percent, a myomectomy was performed. Myomectomy was performed successfully in all 71 of the patients. 
Conclusion: This can be a safe and successful cesarean delivery myomectomy when performed by expert hands and in a well-equipped environment. 

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