DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20202768

Myomectomy during cesarean section: is it a contraindication these days?

Amit Gupta, Anju Vij, Tanu Verma, Molly ., Rajender Kumar, Bharti Gupta

Abstract


Myomectomy during the cesarean section is a debatable procedure because of raised risk of associated uncontrollable hemorrhage and postoperative morbidity. 38 years, elderly primigravida, who conceived after primary infertility with large leiomyoma in the lower uterine segment, underwent myomectomy during the cesarean section. Her intra-operative hemorrhage was within normal limits and post-partum period was uneventful. Conclusion of this study is Safety and feasibility of myomectomy along with cesarean largely depends upon the case selection, experience of the obstetrician and backup ICU and transfusion facilities.


Keywords


Cesarean section, Leiomyoma, Myomectomy

Full Text:

PDF

References


Gupta A, Thakur S, Verma S, Gupta B. Incidental myomectomy along with cesarean section: a case report. Obs Gynae Today. 2004;9(2):80-1.

Kolankaya A, Arici A. Myomas and assisted reproductive technologies: when and how to act?. Obstet Gynecol Clin North Am. 2006;33(1):145-52.

Klatsky PC, Tran ND, Caughey AB, Fujimoto VY. Fibroids and reproductive outcomes: a systematic literature review from conception to delivery. Am J Obstet Gynecol. 2008;198(4):357-66.

Qidwai GI, Caughey AB, Jacoby AF. Obstetric outcomes in women with sonographically identified uterine leiomyomata. Obstet Gynecol. 2006;107(2):376-82.

Lam SJ, Best S, Kumar S. The impact of fibroid characteristics on pregnancy outcome. Am J Obstet Gynecol. 2014;211(4):391-5.

Stout MJ, Odibo AO, Graseck AS, MacOnes GA, Crane JP, Cahill AG. Leiomyomas at routine secondtrimester ultrasound examination and adverse obstetric outcomes. Obstet Gynecol. 2010;116(5):1056-63.

Katz VL, Dotters DJ, Droegemeuller W. Complications of uterine leiomyomas in pregnancy. Obstet Gynecol. 1989;73:593-6.

Depp R. Cesarean delivery. In: Obstetrics: normal and problem pregnancies 4th edition. Edited by: Gabbe SG, Niebyl JR, Simpson JL. New York: Churchill Livingstone; 2002:599.

Baloniak B, Jasinskil O, Prews K. Slomko Z. Morphologic pattern of uterine myomas enucleated at cesarean section. Clinical Pol. 2002;73(4):255-9.

Kwawukume EY. Myomectomy during cesarean section. Int J Gynecol Obstet. 2002;76:183-4.

Pergialiotis V, Sinanidis I, Louloudis E, Vichos T, Perrea DN, Doumouchtsis SK. Perioperative complications of cesarean delivery myomectomy: a meta-analysis. Obstet Gynecol. 2017;130(6):1295-303.

Hatırnaz S, G¨uler O, Bas S¸ Tokg¨oz AC, Kılıc GS. Endometrial myomectomy: a novel surgical method during cesarean section. The J Maternal-Fetal Neonat Med. 2017;31(4):433-8.

Turgal M, Ozgu-Erdinc AS, Beksac K, Ozyuncu O, Karaagaoglu E, Beksac MS. Myomectomy during cesarean section and adhesion formation as a long-term postoperative complication. Ginekologia Polska. 2015;86(6):457-60.

Kant A, Manuja S, Pandey R. Cesarean myomectomy. J Obstet Gynecol India. 2007;57(2):128-30.

Islam MS, Ciavattini A, Petraglia F, Castellucci M, Ciarmela P. Extracellular matrix in uterine leiomyoma pathogenesis: a potential target for future therapeutics. Human Reprod Update. 2018;24(1):59-85.

Velasco VR. Update of the conservative management of the uterine leiomyomata. Analesdela Real Academia Nacional de Medicina. 2006;123(4):841-62.

Okogbo FO, Ezechi OC, Loto OM, Ezeobi PM. Uterine leiomyomata in South Western Nigeria: a clinical study of presentations and management outcome. African Health Sci. 2011;11(2):271-8.