European Journal of Molecular & Clinical Medicine

Abstract

Purpose: Most obstetricians hesitate to perform myomectomy during caesarean section due to a theoretical risk of haemorrhage. The aim of this study is to determine the safety and feasibility of caesarean myomectomy
 Methodology: From January 1, 2010, to January 1, 2019, this 9-year prospective observational study was carried out in a tertiary care teaching hospital in South Kerala, India. The research group, which consisted of all (114) pregnant patients who underwent caesarean myomectomy between January 2010 and January 2019, was compared to 77 non-pregnant patients with fibroids who underwent interval myomectomy during the same time period. The caesarean myomectomies and interval myomectomies done by the same experienced surgeon were taken for the study. Both the groups were compared for the following outcome variables: duration of the surgical procedure, drop in haemoglobin from the pre-operative to post-operative period, length of hospital stay, incidence of post-operative complications like the need for blood transfusion, sepsis etc.
Results: The incidence of haemorrhage in study group was 11.4% as compared with 27% in control group(p=0.02). The incidence of sepsis among the two groups was not statistically significant. No patient in either group required a hysterectomy. Mean length of surgery for caesarean myomectomy  was 91.64 minutes compared to a mean of 109.97 minutes in open myomectomy, which was statistically significant(p=0.000). Average length of hospital stay in caesarean myomectomy was 6.05 days compared to a 6.52 days for open myomectomy, which was statistically significant (p=0.03).
Conclusion: In selected patients, caesarean myomectomy is a safe procedure in tertiary centres with experienced surgeons.