Myomectomy during cesarean section

Ehigiegba, AE; Ande, Adedapo; Ojobo, S.

doi:10.1016/s0020-7292(01)00452-0

Cited by 92 publications

(79 citation statements)

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“…It appears to be safe and best reserved for patients with symptomatic fibroids which are in sub-serosal or pedunculated location and in those affecting the lower uterine segment. Ehigiegba et al [2] removed single fibroids when they were well above 5 cm; in their study, most of patients had multiple fibroids which were intramural in location. They did not remove any posteriorly placed fibroids.…”

Section: Discussionmentioning

confidence: 91%

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Leaving fibroids at caesarean section, is it safe?

et al. 2008

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Most obstetricians try to avoid myomectomy during caesarean section due to associated risks of haemorrhage. Leaving them is not entirely without complications. We report a rare case of spontaneous expulsion of a large fibroid following caesarean section.Keywords Fibroids . Myomectomy . Caesarean myomectomy . Expulsion of fibroids Case reportA 35-year-old woman had a booking scan which suggested a single intra-uterine pregnancy with a 6-cm fibroid in the posterior wall of the uterus. Pregnancy was uneventful in first and second trimester. A repeat scan in second trimester showed increase in size of the fibroid. She went into preterm labour at 34 weeks of gestation and had an emergency caesarean section for mal-presentation. The fibroid in the posterior wall was about 12 cm in size and was left untouched. Post-operative recovery was uneventful and she was discharged home on day 5. She presented to gynaecology assessment unit at 6 weeks post-partum with complaints of persistent foul smelling vaginal discharge for 3 weeks and difficulty in passing urine for 2 days. She gave history of severe cramps in her pelvis 4 days prior to her presentation.Her observations were stable and abdominal examination revealed a distended bladder, catheterisation drained 800 ml of urine and a palpable 20-week uterus was noted.

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Section: Discussionmentioning

confidence: 91%

“…Of the nine cases of caesarean myomectomy reported by Exocoutos and Rosati [1], three were complicated by severe haemorrhage necessitating hysterectomy. Ehigiegba et al [2] studied 25 women who underwent caesarean myomectomy. They used high-dose oxytocin intra-operatively and continued its use for 12-24 h postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Leaving fibroids at caesarean section, is it safe?

et al. 2008

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“…Ehigiegba AE et al have reported that caesarean myomectomy is safe with average per operative and postoperative bleeding. 19 Enucleation of the fibroid is technically easier in gravid uterus due to extra looseness of the capsule and dissection becomes easier. 20 In Kerala there is a high incidence of fibroid in reproductive women and so there occurrence in pregnancy is also high so, obstetrician should be skilled to perform emergency myomectomy if indicated.…”

Section: Discussionmentioning

confidence: 99%

Myoma in pregnancy and outcome after cesarean myomectomy

Valson

Nazer

Mukergee

2017

Int J Reprod Contracept Obstet Gynecol

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Background: The prevalence of leiomyoma is 30% to70% in reproductive women. In addition to causing menstrual disorders like menorrhagia, mass in abdomen, pain and it also negatively affect fertility and pregnancy outcome. Objectives of present study was to investigate the outcome in cases of pregnancy complicated by fibroids undergoing lower segment cesarean section (LSCS) in DM WIMS Medical College and Hospital, Wayanad, Kerala, where the prevalence of fibroids is high in reproductive women.Methods: Twelve cases of leiomyoma with pregnancy underwent LSCS with myomectomy following the delivery of the baby. The indications for myomectomy during LSCS taken into consideration were firstly the size of fibroids usually less than 5 cm, mainly single myoma complicating pregnancy and sites like sub serous and intramural. The suturing of the uterus was done using polyglycolic acid of size No. 1 and polyglycolic acid suture of 2 ‘0’ for closing the dead space and with good hemostasis the operation was completed. The indications for cesarean, the average operative time for surgery, the amount of blood loss, and postoperative complications like surgical site infections were noted and outcome recorded.Results: The time taken for surgery was about 45 minutes longer, average blood loss was approximately 300 ml to 500 ml more than for a routine LSCS. There was no surgical site infections or postpartum hemorrhage in any of the cases.Conclusions: Myomectomy with caesarean in selected cases with proper indications is safe and possible in selected cases. It avoids a second surgery with its associated morbidity.

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“…It is generally advised that myomectomy should be avoided as much as possible during cesarean section because of the substantiated risk of significant hemorrhage. However, reports abound of successful myomectomies during cesarean section [48][49][50]. Myomectomies antenatally by laparotomic or laparoscopic approach prior to fetal viability, most especially in the second trimester of pregnancy, have been rarely carried out as a result of intractable pain from a degenerating fibroid; especially if subserosal and pedunculated, large or rapidly growing, or large fibroid (>5 cm) located in the lower uterine segment [2,47,51].…”

Section: Surgery In Pregnant Women With Uterine Fibroidsmentioning

confidence: 99%

Uterine Fibroids and Pregnancy: A Review of the Challenges

Abam¹,

Kasso²

2017

Obstetrics

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Uterine fibroids are quite common in women of the reproductive age group and as such commonly encountered in pregnancy. Though majority of these cases are asymptomatic, some are prone to developing complications and may end up having adverse outcomes in pregnancy. Management of these women with uterine fibroids presents its own challenges, especially in low-resource setting as in sub-Saharan Africa, where the condition is rife. Adequate management of these women, be it pregnant or nonpregnant, improves their quality of life.

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Myomectomy during cesarean section

Abstract: With adequate experience and the use of high dose oxytocin infusion (intra- and post-operatively), myomectomy at cesarean section is not as hazardous as many now believe.

Cited by 92 publications

References 0 publications

Leaving fibroids at caesarean section, is it safe?

Leaving fibroids at caesarean section, is it safe?

Myoma in pregnancy and outcome after cesarean myomectomy

Uterine Fibroids and Pregnancy: A Review of the Challenges

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