Caesarean Myomectomy to Prevent Immediate or Interval Myomectomy, Hysterectomy and Postpartum Hemorrhage

Abstract

Background & Objective: Uterine fibroids (UF) in pregnancy is a condition, where symptomatic or asymptomatic fibroids in the uterine cavity may cause complications in pregnancies. Placental abruption and preterm labor, occurs in late pregnancy, postpartum hemorrhage, caesarean section and retained placenta in perinatal period. This study aimed to reckon whether the surgical Caesarean myomectomy is still a gold standard in myoma removal in pregnant women. Materials & Methods:This study was retrospectively conducted in pregnant women deliveries with uterine fibroids who underwent Myomectomy with lower segment caesarean section (LSCS). The caesarean myomectomy cases were compared with LSCS alone controls in 1:2 ratio. The primary outcome is to minimize blood loss and need for blood transfusion. The secondary outcome is the length of surgery duration and hospital stay. Results:The outcome of case and control compared was 43 caesarean myomectomy with LSCS as case group and 86 LSCS Alone as control group. The incidence of hemorrhage in case group was 10 out of 43 while control was 2 out of 86 (2.32%) with P-value of 0.0017. The secondary outcome was the length of surgery duration and hospital stay which were found statistically significant between the case and control groups, with P-value = 0.0001 and 0.0072, respectively. Conclusion:Caesarean Myomectomy can be the effective surgical option to enucleate uterine myoma, and preserve uterus and jettison from eventful or symptomatic uterine fibroids. To have the chances for prevention of immediate or interval -myomectomy / hysterectomy and control of post-partum menstrual over bleeding.