Subsequent pregnancy outcomes after abdominal vs. laparoscopic myomectomy

Abstract

Objective

To determine whether abdominal (open) vs. laparoscopic myomectomy affects the obstetrical outcomes of subsequent pregnancies.

Methods

A retrospective cohort study was conducted at a tertiary university medical center. The study population included women who had a documented birth following a myomectomy at our institution between the years 1997 and 2018. The obstetrical characteristics and immediate perinatal outcomes of the subsequent pregnancy following open vs. laparoscopic myomectomy were collected and compared. Data were retrieved from patients’ medical records via the institutional computerized database. Cases that lacked detailed surgery and delivery reports were excluded. Data were analyzed using a chi-square test for categorical variables and one-way ANOVA for continuous variables. A p-value <.05 was considered statistically significant.

Results

During the study period, 57 women met the inclusion criteria, of whom 66.6% (38/57) had an open and 33.3% (19/57) had a laparoscopic myomectomy. Women who underwent an open myomectomy had a higher rate of cesarean birth than those in the laparoscopic group (89.5 vs. 42.1%, p < .001). No cases of severe maternal or perinatal complications, uterine ruptures, or placental abruptions were identified in either study group. No other significant differences were noted between the two types of myomectomy.

Conclusion

Open myomectomy is associated with a higher rate of cesarean delivery than laparoscopic. No severe adverse maternal or neonatal outcomes were detected in either study group.

Keywords:

• Myomectomy
• laparoscopic myomectomy
• abdominal (open) myomectomy
• uterine rupture
• obstetric outcome
• perinatal outcome

Disclosure statement

The authors declare no conflicts of interest relevant to this article. We confirm that no honorarium, grant, or other forms of payment was given to any of the authors to produce the manuscript. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Author contributions

Dr. Elihai Haviv: investigation, writing – original draft. Dr. Polina Schwarzman: conceptualization, methodology, investigation, review, and editing, Eli H. Bernstein: investigation, writing – review, and editing. Prof. Tamar Wainstock: investigation, methodology, formal analysis, review, and editing. Prof. Adi Weintraub: conceptualization, methodology, investigation, writing – review, and editing. Dr. Elad Leron: review and editing. Prof. Ofer Erez: conceptualization, methodology, investigation, writing – review, and editing.