Abstract
Objective
In this study, we evaluate the safety and feasibility of cesarean myomectomy and compare this procedure with abdominal myomectomy in single fibroid, in terms of blood loss and postoperative complications.
Methods
Thirty-three patients who underwent cesarean myomectomy from June 2006 to 2012 in Amrita Institute of Medical Sciences, were included in the study. Almost an equal number of patients who underwent abdominal myomectomy (32) in the same period were included. Women are divided into two groups: group 1—cesarean myomectomy, group 2—abdominal myomectomy.
Results
Mean age of the women was comparable; mean gestational age in group 1 was 37.97 +/− 1.57 weeks; and 60 % were primiparous. Hemoglobin (Hb) drop postoperatively was compared between the groups, and there was no significant difference. Though there was statistically significant difference among the groups regarding the size of fibroids, the main outcome measure of the study, the Hb drop was comparable between group 1 and 2. There is statistically significant difference in the Hb difference with increasing mean diameter of the fibroids. As the size increases, Hb drop also increases indicating the increasing blood loss. The measures used to reduce blood loss such as vasopressin instillation and stepwise devascularization influence the blood loss, and P value shows borderline significance. There was no difference in Hb drop among the groups according to the type of fibroids. But more subserous fibroids were removed in group 1, whereas more intramural fibroids were removed in group 2.
Conclusion
Cesarean myomectomy can be safely done in single fibroids and is comparable to abdominal myomectomy in terms of blood loss.
Similar content being viewed by others
References
Neiger R, Sonek JD, Croom CS, et al. Pregnancy-related changes in the size of uterine leiomyomas. J Reprod Med. 2006;51(9):671–4.
Muram D, Gillieson MS, Walters JH. Myomas of the uterus in pregnancy: ultra sonographic follow-up. Am J Obstet Gynecol. 1980;138:16–9.
Hammoud AO, Asaad R, Berman J, et al. Volume change of uterine myomas during pregnancy: do myomas really grow? J Minim Invasive Gynaecol. 2006;13(5):386–90.
Li H, Du J, Jin L, et al. Myomectomy during cesarean section. Acta Obstet Gynecol Scand. 2009;88(2):183–6.
Roman AS, Tabsh KMA. Myomectomy at time of cesarean delivery: a retrospective cohort study. BMC Pregnancy Childbirth. 2004;4:14–7.
Owolabi AT, Kuti O, Loto OM, et al. Caesarean myomectomy-a safe procedure: a retrospective case controlled study. Nepal J Obstet Gynaecol. 2007;2(2):59–62.
Kwawukume EY. Caesarean myomectomy. Afr J Reprod Health. 2002;6(3):38–43.
Adesiyun AG, Ameh AC, Ojabo A. Myomectomy at caesarean section: descriptive study of clinical outcome in a tropical setting. J Ayub Med Coll Abbottabad. 2009;21(4):7–9.
Adesiyun AG, Ojabo A, Durosinlorun-Mohammed A. Fertility and obstetric outcome after caesarean myomectomy. J Obstet Gynaecol. 2008;28(7):710–2.
Compliance with Ethical Requirements and Conflict of Interest
The study was approved by the Institute ethical committee, and informed consent has been taken from all the patients who were included in the study. Mangala Kanthi Janu, Sudha Sumathy, Sreedhar Sarala, B. Rajammal, M. G. Usha, and V. S. Sheejamol declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kanthi, J.M., Sumathy, S., Sreedhar, S. et al. Comparative Study of Cesarean Myomectomy with Abdominal Myomectomy in Terms of Blood Loss in Single Fibroid. J Obstet Gynecol India 66, 287–291 (2016). https://doi.org/10.1007/s13224-015-0685-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13224-015-0685-x