Analysis of Myomectomy during Cesarean Section: A Tertiary Center Experience

Sakıncı, Mehmet; Turan, Gökçe; Sanhal, Cem Yaşar; Yıldız, Yunus; Hamidova, A; Güner, Fatma Ceren; Buyuk, Alime; Doğan, Nasuh Utku; Olgan, Şafak

doi:10.1080/08941939.2020.1810832

Cited by 11 publications

(14 citation statements)

References 26 publications

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“…Kim et al (20) retrospective study on non-complicated and complicated women of CM found that the complicated group had a fibroid with a diameter larger than 10 cm. In the recent study of Sakinciet al (6) , there was a statistically significant and inverse correlation between the size of the myoma and the delivery week, this is consistent with this study findings. The attributed reason may be that the increased contractility of the myometrium as the gestational weeks progress because of the presence of large myomas.…”

Section: Discussionsupporting

confidence: 91%

“…In addition, in the current study, a significant statistical difference (14 min) in the duration of surgery between the groups was noted. Consistently, in the studies of Sakinci et al (6) and Guler et al (7) , myomectomy added 15, 14 min to the CS duration. Morzak et al (8) and Nargis et al (9) reported a significant difference regarding the operation time and the hospital stay length In another similar study, the CS duration was only 4.94 minutes longer in the myomectomy group than it was in the nonmyomectomy group, which was not a significant difference (10) .…”

Section: Discussionmentioning

confidence: 61%

“…However, the CM group was only about 11 hours longer than the myomectomy group. In the recent study of Sakinci et al (6) , hospital stay length and duration of surgery were significantly longer in CM patients when compared with only CS patients. Another study compared cesarean myomectomy and cesarean delivery alone regarding the change of hemoglobin concentration, the need for blood transfusion, and the operative time and found only increased operative time in the cesarean myomectomy group (7) .…”

Section: Discussionmentioning

confidence: 86%

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Myomectomy for Fibroids during Cesarean Section: A Randomized Controlled Trial

Shabana¹,

Sayyed²,

Rezk³

et al. 2021

The Egyptian Journal of Hospital Medicine

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Background: There is a considerable debate about the management of myoma during cesarean section (CS). Recently, several studies indicated the safety and feasibility of undertaking myomectomy during CS. Objectives: To evaluate the safety, accessibility, and short-term morbidity of myomectomy for fibroids during cesarean section. Patients and Methods: This was a randomized controlled trial that included 72 patients who were admitted to the Obstetrics & Gynecology Department, Menoufia University Hospital with uterine fibroids during pregnancy; who were randomly allocated equally into a group of cesarean myomectomy (CM; n=36) and another group of CS only (n=36). The operative events and the outcome were recorded and analyzed. Results: CM group showed a longer duration of surgery and longer hospital stay, higher amount of blood loss, and higher mean pain sores, with a highly statistically significant difference (p = 0.000). No cases in both groups required blood transfusion or ICU admission. No statistically significant differences were noted between both groups as regards the fetal outcome measures (p=0.583 & 0.601). Conclusion: CM is safe and applicable in selected cases without deleterious maternal complications. Special precautions ought to be paid during the procedure, particularly in the intramural type and with large fibroids.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 86%

See 1 more Smart Citation

Myomectomy for Fibroids during Cesarean Section: A Randomized Controlled Trial

Shabana¹,

Sayyed²,

Rezk³

et al. 2021

The Egyptian Journal of Hospital Medicine

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“…The mean gestational age at delivery was signi cantly lower in the CM group and this might have been due to the increased contractility of the myometrium with the presence and mass effect of the leiomyoma [9]. For similar reasons, the incidence of preterm labor was increased signi cantly in the CM group in our study.…”

Section: Discussionsupporting

confidence: 63%

“…In a previous report, the operation time was 4.94 minutes longer in the CM group than the CS-only group, which was not a signi cant difference [12]. In another study, the operation time in the CM group was 15 minutes longer than that of the CS-only group and this was a signi cant result [9].…”

Section: Discussionmentioning

confidence: 78%

The Trend in Cesarean Myomectomies and The Risk of Obstetrical Complications in Korea

Kim

Lee

Park

et al. 2021

Preprint

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Background To evaluate the pregnancy outcomes and the risk of adverse obstetrical outcomes from cesarean myomectomy (CM) compared to cesarean section (CS)-only and to investigate the trend of surgeons in choosing CM. Methods A retrospective cohort study was done of all patients who underwent CS that was complicated with leiomyoma at two university hospitals from January 2010 to May 2020. All patients were categorized into the CM group or the CS-only group. We analyzed the demographic factors, obstetric factors, surgical outcomes, and possible risk factors for adverse outcomes between the two groups. Results A total of 438 women in the CS-only group and 341 women in the CM group were included. Women who underwent CS-only had significantly more history of a previous myomectomy and multiple leiomyomas compared to women who underwent CM. The gestational days at delivery and the pregnancy complications were significantly higher in the CS group. The mean size of the leiomyomas was larger in the CM group than in the CS only group (5.8 ± 3.2 cm vs 5.2 ± 3.1 cm, P = 0.005). Operation time and history of previous CS and preterm labor were higher in the CM group. It seems that preterm labor and abnormal presentation were relatively higher in the CM group than in the CS group due to the presence of leiomyoma. There were no significant differences in the pre and postoperative hemoglobin levels. The size of the leiomyoma (odds ratio [OR] = 1.162; 95% confidence interval [CI]: 1.07 – 1.25; P < 0.001) and operation time > 60 minutes (OR = 2.461; 95% CI: 1.45 – 4.15) were significant independent predictors of adverse outcomes after CM. Conclusions Cesarean myomectomy is a reliable and safe approach to prevent the need for another operation for remnant leiomyoma. In this study, surgeons seemed to perform CM when uterine leiomyomas were large, the subserosal type, or few in number. Standardized treatment guidelines for myomectomy during cesarean section in pregnant women with uterine fibroids should be established.

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The trend in cesarean myomectomies and the risk of obstetrical complications in Korea

Kim

Lee

Park

et al. 2022

BMC Pregnancy Childbirth

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Background To evaluate pregnancy outcomes and the risk of adverse obstetrical outcomes of cesarean myomectomy (CM) compared with cesarean section (CS) only, and to investigate the trend of surgeons in choosing CM. Methods A retrospective cohort study was performed on all patients who underwent CS complicated by leiomyoma at two university hospitals between January 2010 and May 2020. All patients were categorized into the CM (341 women) or CS-only (438 women) group. We analyzed the demographic factors, obstetric factors, surgical outcomes, and possible risk factors for adverse outcomes between the two groups. Results Women who underwent CS only were significantly more likely to have a previous myomectomy and multiple leiomyoma history than women who underwent CM. The gestational age at delivery and pregnancy complications were significantly higher in the CS-only group. The mean size of the leiomyomas was larger in the CM group than in the CS-only group (5.8 ± 3.2 cm vs. 5.2 ± 3.1 cm, P = 0.005). The operation time and history of previous CS and preterm labor were higher in the CM group. The leiomyoma types differed between the two groups. The subserosal type was the most common in the CM group (48.7%), and the intramural type was the most common in the CS-only group. Patients in the CM group had fewer than three leiomyomas than those in the CS-only group. Preterm labor and abnormal presentation were relatively higher in the CM group than in the CS-only group, concerning leiomyoma presence. There were no significant differences in the preoperative and postoperative hemoglobin levels. The size of the leiomyoma (odds ratio [OR] = 1.162; 95% confidence interval [CI]: 1.07–1.25; P < 0.001) and operation time > 60 min (OR = 2.461; 95% CI: 1.45–4.15) were significant independent predictors of adverse outcomes after CM. Conclusions CM should be considered a reliable and safe approach to prevent the need for another surgery for remnant leiomyoma. Herein, surgeons performed CM when uterine leiomyomas were large, of the subserosal type, or few. Standardized treatment guidelines for myomectomy during CSs in pregnant women with uterine fibroids should be established.

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Analysis of Myomectomy during Cesarean Section: A Tertiary Center Experience

Cited by 11 publications

References 26 publications

Myomectomy for Fibroids during Cesarean Section: A Randomized Controlled Trial

Myomectomy for Fibroids during Cesarean Section: A Randomized Controlled Trial

The Trend in Cesarean Myomectomies and The Risk of Obstetrical Complications in Korea

The trend in cesarean myomectomies and the risk of obstetrical complications in Korea

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