SAFETY OF CAESAREAN MYOMECTOMY
AbstractBackground: 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
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
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
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
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
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
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
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.