Electro-cautery of myomas during caesarean section—two case reports

Caesarean Myomectomy As Safe And Feasible Procedure: Prospective Study of 6 Cases.

“…7 Several authors have now shown that in selected patients and in experienced hands, myomectomy at the time of caesarean section is a safe and effective procedure. 3,[7][8][9][10][11][12][13][14][15][16][17][18] In our study series, blood losswas less than 1.2 L of blood and there was no significant postoperative morbidity.Despite the majority of the patients having large myomas, no hysterectomy was required in any patient. The diagnosis fibroids was confirmed by the pathology reports.…”

“…[6]However, a number of recent studies have favoured Caesarean myomectomy. [3,[7][8][9][10][11][12][13][14][15][16][17][18] Though myomectomy during caesarean is still condemned, caesarean myomectomy is now favoured in selected cases and experienced hands. The former has concerns such as risk of surgery and anaesthesia in antenatal period, postoperative adhesions, increased likelihood of subsequent caesarean at the time of delivery including a rare risk of myomectomy scar rupture, increased cost and discomfort owing to two surgeries in a short span of time.…”

Caesarean Myomectomy : Feasibility and Safety = عملية إستئصال ورم الرحم العضلي أثناء إجراء العملية القيصرية : إمكانية إجراء العملية و السلامة

“…11 Recent studies have described techniques to minimise blood loss at Caesarean myomectomy including uterine tourniquet, bilateral uterine artery ligation, and electrocautery. 10,12,13 In our series, stepwise devascularisation was required to control atonic PPH in one patient; in another patient uterine artery balloon catheters were placed preoperatively. Several authors have now shown that in selected patients and in experienced hands, myomectomy at the time of caesarean section is a safe and effective procedure.…”

“…However, a number of authors have recently shown that myomectomy at Caesarean does not increase the risk of haemorrhage. 2,[10][11][12][13][14][15][16][17][18][19][20][21] We present a series of 8 cases where myomectomy was performed during Caesarean section for large lower segment fibroids ranging in size from 4 to 12 cms. The antenatal course, perioperative management, and postoperative morbidity are discussed.…”

Blood loss during Caesarean Myomectomy: A retrospective analysis of 36 cases carried out at a Cottage Hospital in the Niger Delta Region of Nigeria

“…The contraction of uterine muscle fibres which is further enhanced by the oxytocic closes the blood vessels, and increase incoagulability during pregnancy also aids clot formation.The use of vascular occlusion method by application of cervical tourniquet has also been described by Owolabiet al, and the mean blood loss was found to be 589ml (300-1300ml). Other methods that can also be used to reduce blood loss are electrocautery (Cobellis et al, 2002) and bilateral uterine artery ligation (Sampaz et al, 2003).…”