Is Myomectomy during Caesarean Section a Safe Procedure? Prospective Cohort Study
• 2021
Publication Information
Authors
Khalid salama and Ibrahim Souidan
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publication.type
Local
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Abstract
Background: Benign uterine myoma is the commonest female
tumor in the reproductive tract, and its incidence in pregnancy
was estimated to be 2% to 5%. Traditionally, cesarean
myomectomy was rejected as there is a liability of intrapartum
and postpartum hemorrhage. The aim of this work is to
investigate the significance of cesarean myomectomy together
with early impact on the mother. Patients and methods: This
study was conducted on 73 patients having different types and
sizes of myoma during caesarean section delivery, the
myomectomy was done by traditional technique but timing of
myomectomy either pre or post delivery of the baby varied
between different cases .Infusion of oxytocin during the operation
and for 24 h later. Results: All women with uterine myoma were
aging from 20- 38 years and had different parity. The
participating women had myoma with different characteristics
mostly from 5-10 cm. Also, the commonest types were intramural alone and sub-serous alone (76.8%). The commonest sites of fibroid were the uterine fundus and
upper segment (80%).Intrapartum hemorrhage occurred in 10 cases that were overcome by
ecbolics and bilateral uterine artery ligations with or without B-lynch technique. Five cases
suffered from post operative fever that was overcome by antibiotics and antipyretics. The post
partum hospital stay was 3 days in 63% of cases .Conclusion: caesarean myomectomy is a safe
procedure but can be only done by experienced surgeon with some precautions.
tumor in the reproductive tract, and its incidence in pregnancy
was estimated to be 2% to 5%. Traditionally, cesarean
myomectomy was rejected as there is a liability of intrapartum
and postpartum hemorrhage. The aim of this work is to
investigate the significance of cesarean myomectomy together
with early impact on the mother. Patients and methods: This
study was conducted on 73 patients having different types and
sizes of myoma during caesarean section delivery, the
myomectomy was done by traditional technique but timing of
myomectomy either pre or post delivery of the baby varied
between different cases .Infusion of oxytocin during the operation
and for 24 h later. Results: All women with uterine myoma were
aging from 20- 38 years and had different parity. The
participating women had myoma with different characteristics
mostly from 5-10 cm. Also, the commonest types were intramural alone and sub-serous alone (76.8%). The commonest sites of fibroid were the uterine fundus and
upper segment (80%).Intrapartum hemorrhage occurred in 10 cases that were overcome by
ecbolics and bilateral uterine artery ligations with or without B-lynch technique. Five cases
suffered from post operative fever that was overcome by antibiotics and antipyretics. The post
partum hospital stay was 3 days in 63% of cases .Conclusion: caesarean myomectomy is a safe
procedure but can be only done by experienced surgeon with some precautions.
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