Myomectomy during Caesarean Section: Safety and Feasibility of the Procedure

  • Hosne Ara Baby Consultant, Infertility Care and Research Center, Dhaka
  • Mosammat Rashida Begum Chief Consultant, Infertility Care and Research Center, Dhaka
  • Mariya Ehsan Ex Medical Officer, Infertility Care and Research Center, Dhaka
  • Nazia Ehsan Medical Officer, Infertility Care and Research Center, Dhaka
  • Iftekhar Amin Medical Officer, Infertility Care and Research Center, Dhaka
  • Ashik Ahmed Chowdhury Medical Officer, Infertility Care and Research Center, Dhaka
  • Farzana Khan Senior Medical Officer, Infertility Care and Research Center, Dhaka
  • Farhana Sharmin Medical Officer, Infertility Care and Research Center, Dhaka
  • Mosammat Shahina Begum Consultant, Infertility Care and Research Center, Dhaka
Keywords: Myoma, Myomectomy, caesarean myomectomy

Abstract

Objective (s): Aim of the study was to evaluate the safety and feasibility of myomectomy during cesarean section.

Materials and methods: This prospective observational study was carried out in a private setting at Dhaka city from January 2006 to June 2015. Forty five (45) women with fibroid uterus with pregnancy who needed caesarean section were the target population for this study. Myomectomy was done during caesarean section. Main outcome measures were: difficulty of myomectomy and caesarean section, time needed for operation, per-operative complications, need for blood transfusion, postoperative complications and duration of hospital stay.

Results: During the study period total 45 women were found who had pregnancy with myoma and needed caesarean section for various indications. Twenty nine (64.4%) women were of age 26-35 years, 30 (66.7%) were para 0 and in 37 (82%) cases were term pregnancy. In forty one (91.1%) cases myomas were diagnosed preoperatively. Twenty five (55.6%) women had multiple myomas. Commonest site of myoma was body of the uterus (82.2%) and commonest type was intramural (75.6%). Thirty (66.7%) women had myoma of less than 5cm in size. In forty two (93.3%) cases myomectomy was done after delivery of the baby. Myomectomy was successful in all 45 (100%) cases. In thirty (80%) cases caesarean myomectomy was completed within 1 hour. Thirty seven (82.2%) women did not need blood transfusion and thirty eight (84.4%) women had no postoperative complication. Other had minor complications. Forty one (90.1%) women were discharged from hospital within 72 hours of operations.

Conclusion: Myomectomy during cesarean section is a safe procedure and it is feasible in almost all cases. Though large scale RCT is needed before giving final conclusion it is not far away when myomectomy during cesarean section will be norm discarding the traditional view of not touching the myoma in pregnancy

Bangladesh J Obstet Gynaecol, 2015; Vol. 30(1) : 10-14

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Author Biography

Hosne Ara Baby, Consultant, Infertility Care and Research Center, Dhaka


Published
2016-11-28
How to Cite
Baby, H., Begum, M. R., Ehsan, M., Ehsan, N., Amin, I., Chowdhury, A., Khan, F., Sharmin, F., & Begum, M. S. (2016). Myomectomy during Caesarean Section: Safety and Feasibility of the Procedure. Bangladesh Journal of Obstetrics & Gynaecology, 30(1), 10-14. https://doi.org/10.3329/bjog.v30i1.30500
Section
Original Articles