Outcomes of Myomectomy at the Time of Cesarean Section among Pregnant Women with Uterine Fibroids: A Retrospective Cohort Study

Abstract

Objective. A retrospective study was performed to evaluate the safety and feasibility of cesarean myomectomy among pregnant women with uterine fibroids (UFs). Methods. Upon data collection, the pregnant women with UF underwent cesarean section in the 39 hospital divided into two groups: cesarean myomectomy group, receiving cesarean section and myomectomy; cesarean group, receiving cesarean section only. Information about the type, location, and number of UFs was collected from the medical records or the prenatal ultrasound examinations. Results. In the cesarean myomectomy group, the proportion of subserous UFs was significantly higher than the cesarean group (65.6% versus 49.3%, P < 0.0001). The comparison of postpartum hemorrhage, neonatal weight, fetal distress, and neonatal asphyxia showed no statistical significance. Multivariate logistic regression analysis demonstrated that birth weight ≥4000 g (OR 3.1, 95% CI:1.6–6.0) and presence of diameter > 5 cm fibroids (OR 2.2, 95%CI:1.3–4.0) were high risk factors for PPH ≥1,000 ml. Conclusions. Myomectomy during cesarean section was a common procedure in mainland China. Myomectomy cesarean could be safe and feasible based on the estimation by experienced obstetricians. During the procedure, special attention should be paid to a large-sized leiomyoma ≥5cm and birth weight ≥4,000 g.

Making caesarean myomectomy safe and feasible: a 12 year single center experience

“…Zhao R et al found that myomectomy was performed more frequently with sub serous fibroids and was avoided in intramural and cervical fibroids. 8 The literature offers only one absolute contraindication to CM i.e. the intra surgical uterine hypotony atony following the delivery of fetus.…”

How Medically Favorable Is the Replacement of the Invasive Colonoscopy With Cologuard Non-Invasive Colorectal Cancer Screening?

“…This data collection is approved for studies involving anything from cesarean section complications to head and neck cancer diagnoses. 15,16 Due to the fact that the restrictions of the AP course did not make a randomized controlled trial feasible as a study type, not all statistics regarding the Cologuard test could be analyzed. Though it would have been preferable to conduct a statistical analysis with both sensitivity and specificity, determining specificity from secondary data collected in the past is not possible.…”

Cesarean myomectomy: Safe operation or surgical folly?

“…However, large case series published over the past 10 years report that, in limited clinical situations, cesarean myomectomy is a viable surgical option, where benefit may outweigh risk. [6][7][8][9][10][11][12][13][14] The current literature has many weaknesses, including failure to specifically identify the indication for the cesarean myomectomy and lack of controlled prospective clinical trials. In almost all cases, cesarean myomectomy is performed after delivery of the fetus and placenta.…”