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Indian Journal of Obstetrics and Gynecology Research


Cesarean Myomectomy: Practical Issues


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Author Details: Preet Kamal, Ripan Bala, Madhu Nagpal, Harmanpreet Kaur

Volume : 4

Issue : 3

Online ISSN : 2394-2754

Print ISSN : 2394-2746

Article First Page : 249

Article End Page : 253


Abstract

Objective: To determine the feasibility, safety and outcome of cesarean myomectomy.
Methods: It was a prospective study carried out in 25 pregnant women who had uterine myomas and underwent myomectomy during elective or emergency cesarean section. Analysis was done with reference to age, parity, characteristics of uterine myomas, operative morbidity, haematological changes occurring between preoperative and postoperative periods. Duration of surgery and post-operative duration of stay in hospital was also analysed. All cesarean myomectomies were performed by senior obstetrician. Followup of all the patients was done after six weeks.
Results: Cesarean myomectomy helps in preventing repeat surgery for myomas and thereby prevents the risk of repeat anesthesia and relaparotomy. In our study forty fibroids of various sizes (2-12 cm) were removed in 25 women during cesarean section. Majority of fibroids were located on anterior wall of uterus except one which was located on the posterior wall of the body of uterus and was submucosal. Majority of the fibroids were detected in the body of uterus and were of subserous and intramural type. Insignificant difference was found in mean preoperative (11.5±0.9 gm/dl) and postoperative haemoglobin(10.7± 0.7gm/dl).Post-operatively only two patients required blood transfusion and one patient had fever. Mean time taken for operation was 63.9± 6.34 minutes and mean post-operative duration of hospital stay was 7.2 ± 1.7 days only. No patient had postpartum haemorrhage requiring cesarean hysterectomy in our study.
Conclusion: Cesarean myomectomy is safe surgical procedure without any significant complications if performed in selected patients by experienced Obstetrician in tertiary care centre.

Keywords:
Cesarean section, Myomectomy, Hysterectomy, Fibroids