SAFETY OF CAESAREAN MYOMECTOMY

Authors

  • Ruqqia Sultana
  • Shehla Noor
  • Ali Fawwad Nazar
  • Nasreen Abbasi
  • Rubina Bashir
  • Bushra Khan
  • Faiza Saleem

Abstract

Background: Uterine fibroids are the most common type of tumours in women arising from uterinemyometrium and less commonly from cervix. Objective of the study was to check the safety ofcaesarean myomectomy. Methods: Patients attending Gynaecology-B Unit of Ayub Teaching Hospitalhaving pregnancy with fibroid and undergoing myomectomy along with caesarean section (CS) wereincluded in this prospective study during Jan 2010–Dec 2011. Intra-operative and postoperativematernal morbidity in terms of blood loss, operative time and length of hospital stay was compared tomatched pregnant woman with caesarean section alone. Results: Out of 6,000 antenatal mothersregistered during the study period myoma was detected in 96 (1.6%) cases. Mean age of mother havingmyoma was 28 years, 70% were primigravida, and mean haemoglobin was 10.56 gm%. Size of myomawas 12 Cm in 30% cases 5 Cm in 23% and more than 1 myoma in 60% cases. There was no significantdifference in intra-operative haemorrhage and length of hospital state in comparison matched womenwith CS although operating time was double than later. None required caesarean hysterectomy.Conclusion: Myomectomy can be safely performed in majority of carefully selected patients withmyomas without any serious life threatening complications.Keywords: Fibroids, caesarean section, myomectomy, haemorrhage

References

Liu WM, Wang PH, Tang WL, Wang IT, Tzeng CR. Uterine

artery ligation for treatment of pregnant women with uterine

leiomyomas who are undergoing cesarean section. Fertil

Steril 2006;86:423–8.

Vergani P, Locatelli A, Ghidini A, Andreani M, Sala F, Pezzullo

JC. Large uterine leiomyomata and risk of cesarean delivery.

Obstet Gynecol 2007;109:410–4.

Ouyang DW. Obstetric complications of fibroids. Obstet

Gynecol Clin North Am 2006;33:153–69.

Cramer S, Patel A, Frequency of uterine fibroids. Am J Clin

Pathol 1990;94:435–8.

Depp R. Caesarean Delivery. In: Gabbe SG, Niebly JR Simpson

Jl, (Eds). Obsterics: Normal and Problem Pregnancies. 4th ed.

New York: Churchill Living Stone; 2002. p. 599.

Cunningham FG, Gant NF, Lavenok KJ, Gilstap LC, Haulth JC,

Wenstrom KD. Abnormalities of the reproductive tract. Williams

Obstetrics, 21st ed. New York: MacGraw Hill; 2001. p. 930.

Michalas SP, Oreopoulou FV, Papageorgiou JS. Myomectomy

during pregnancy and caesarean section. Hum Reprod

;10(7):1869–70.

Burton CA, Grimes DA, March CM. Surgical management of

leiomyomata during pregnancy. Obstet Gynecol 1989;74(5):707–9.

Exacoustòs C, Rosati P. Ultrasound diagnosis of uterine

myomas and complications in pregnancy. Obstet Gynecol

;82(1):97–101.

Kiran A, Lata A, Ashok A, Agrawal VK, Kanupriya A.

Caesarean Myomectomy: Prospective Study. National

Journal of Integrated Research in Medicine 2011;2(3):11–4.

Omar SZ, Sivanesaratnam V, Damodaran P. Large lower

segment myoma: Myomectomy at lower segment section —a

report of two cases. Singapore Med J 1999;40:109–10.

Kwawukume EY. Caesarean myomectomy. Afr J Reprod Health

;6(3):38–43

Brown M, Myrie M. Caesarean myomectomy —a safe

procedure. West Indian Med J 1997;46(Suppl 2):45.

Howkins J, Stallworthy J. Bonney’s Gynecological Surgery, 8th

ed. London: Bailliere Tindall; 1974.

Roman AS, Tabsh KM. Myomectomy at time of caesarean

delivery: a retrospective cohort study. BMC Pregnancy

Childbirth 2004;4(1):14.

Published

2012-06-01

Most read articles by the same author(s)

<< < 1 2 3 > >>