Myomectomy for intramural fibroids during caesarean section: A therapeutic dilemma

Abstract

The aim of the present study was to assess the safety of myomectomy for intramural fibroids during caesarean section. A retrospective study of 63 women who underwent myomectomy during caesarean section and 63 women who underwent caesarean delivery without myomectomy was conducted. The study group was divided into subgroups according to the volume of fibroids and total incision count. The volume of fibroids, the preoperative and postoperative haemoglobin values and the difference between them, incidence of haemorrhage and blood transfusion, duration of operation and postoperative fever of patients were investigated. Duration of operation was longer (p < .001) and haemoglobin loss was higher (p = .01) in the myomectomy group. There was no difference between one incision and two incisions subgroups in terms of mean haemoglobin change (p = .068). Haemoglobin loss was higher in volume >50 cm³ group than volume <50 cm³ and control groups. These differences were statistically significant (p = .02; p = .001, respectively). Although intramural fibroids can be safely removed during caesarean section, large fibroids and extra incisions for myomectomy are risk factors for haemorrhage.

Keywords:

• cesarean section
• myomectomy
• fibroid

Disclosure statement

All authors have stated explicitly that there are no conflicts of interest in connection with this article. We have full control of all primary data and agree to allow the journal to review our data if requested.