Caesarean Myomectomy; Feasibility and safety
Objectives: Caesarean myomectomy has traditionally been discouraged due to fears of intractable haemorrhage and increased postoperative morbidity. However, a number of authors have recently shown that myomectomy during Caesarean section does not increase the risk of haemorrhage or postoperative morb...
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| Format: | Article |
| Language: | English |
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Sultan Qaboos University
2012-05-01
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| Series: | Sultan Qaboos University Medical Journal |
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| Online Access: | http://web.squ.edu.om/squmj/includes/tng/pub/tNG_download.asp?id=ed151cd7da47e0b8928d231e2e2f0d00 |
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| author | Lovina SM Machado Vaidyanathan Gowri Nihal Al-Riyami Lamya Al-Kharusi |
| author_facet | Lovina SM Machado Vaidyanathan Gowri Nihal Al-Riyami Lamya Al-Kharusi |
| author_sort | Lovina SM Machado |
| collection | DOAJ |
| description | Objectives: Caesarean myomectomy has traditionally been discouraged due to fears of intractable haemorrhage and increased postoperative morbidity. However, a number of authors have recently shown that myomectomy during Caesarean section does not increase the risk of haemorrhage or postoperative morbidity. Methods: We present a series of 8 cases from Sultan Qaboos University Hospital, Oman, where myomectomy was
performed during Caesarean section for large lower segment fibroids. Seven were anterior lower segment fibroids, while one was a posterior lower uterine fibroid which interfered with closure of the uterine incision. The antenatal course, perioperative management, and postoperative morbidity are discussed. Results: The average age of the women was 28.7 years and mean gestational age at delivery was 36.75 weeks. Regarding intra-operative blood loss, 1 patient lost 900 ml, 5 patients lost 1–1.5 litres, 2 lost 1.5–2 L, and 1 patient with a 10 x 12 cm fibroid lost 3.2 L. Despite the majority being large myomas (7 of the 8 patients had myomas >5 cm in size) and 50% being intramural,
no hysterectomy was required. Stepwise devascularisation was necessary in one case and preoperative placement of uterine balloon catheters was necessary in another. The size of the fibroids was confirmed by histopathology. Myomectomy added 15 minutes to the operating time and 1 day to the hospital stay, but there was no significant postoperative morbidity. Neonatal outcome was good in all patients. Conclusion: In selected patients, myomectomy during Caesarean section is a safe and effective procedure at tertiary centres with experienced surgeons. |
| first_indexed | 2024-04-12T20:37:19Z |
| format | Article |
| id | doaj.art-ab737873feda4626a0556465a222859f |
| institution | Directory Open Access Journal |
| issn | 2075-051X 2075-0528 |
| language | English |
| last_indexed | 2024-04-12T20:37:19Z |
| publishDate | 2012-05-01 |
| publisher | Sultan Qaboos University |
| record_format | Article |
| series | Sultan Qaboos University Medical Journal |
| spelling | doaj.art-ab737873feda4626a0556465a222859f2022-12-22T03:17:33ZengSultan Qaboos UniversitySultan Qaboos University Medical Journal2075-051X2075-05282012-05-01122190196Caesarean Myomectomy; Feasibility and safetyLovina SM Machado0Vaidyanathan Gowri1Nihal Al-Riyami2Lamya Al-Kharusi3Department of Obstetrics & Gynaecology, Sultan Qaboos University Hospital, Muscat, OmanDepartment of Obstetrics & Gynaecology , College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, OmanDepartment of Obstetrics & Gynaecology, Sultan Qaboos University Hospital, Muscat, OmanDepartment of Obstetrics & Gynaecology, Sultan Qaboos University Hospital, Muscat, OmanObjectives: Caesarean myomectomy has traditionally been discouraged due to fears of intractable haemorrhage and increased postoperative morbidity. However, a number of authors have recently shown that myomectomy during Caesarean section does not increase the risk of haemorrhage or postoperative morbidity. Methods: We present a series of 8 cases from Sultan Qaboos University Hospital, Oman, where myomectomy was performed during Caesarean section for large lower segment fibroids. Seven were anterior lower segment fibroids, while one was a posterior lower uterine fibroid which interfered with closure of the uterine incision. The antenatal course, perioperative management, and postoperative morbidity are discussed. Results: The average age of the women was 28.7 years and mean gestational age at delivery was 36.75 weeks. Regarding intra-operative blood loss, 1 patient lost 900 ml, 5 patients lost 1–1.5 litres, 2 lost 1.5–2 L, and 1 patient with a 10 x 12 cm fibroid lost 3.2 L. Despite the majority being large myomas (7 of the 8 patients had myomas >5 cm in size) and 50% being intramural, no hysterectomy was required. Stepwise devascularisation was necessary in one case and preoperative placement of uterine balloon catheters was necessary in another. The size of the fibroids was confirmed by histopathology. Myomectomy added 15 minutes to the operating time and 1 day to the hospital stay, but there was no significant postoperative morbidity. Neonatal outcome was good in all patients. Conclusion: In selected patients, myomectomy during Caesarean section is a safe and effective procedure at tertiary centres with experienced surgeons.http://web.squ.edu.om/squmj/includes/tng/pub/tNG_download.asp?id=ed151cd7da47e0b8928d231e2e2f0d00Caesarean sectionMyomectomyFibroidsPregnancyHaemorrhageOman |
| spellingShingle | Lovina SM Machado Vaidyanathan Gowri Nihal Al-Riyami Lamya Al-Kharusi Caesarean Myomectomy; Feasibility and safety Sultan Qaboos University Medical Journal Caesarean section Myomectomy Fibroids Pregnancy Haemorrhage Oman |
| title | Caesarean Myomectomy; Feasibility and safety |
| title_full | Caesarean Myomectomy; Feasibility and safety |
| title_fullStr | Caesarean Myomectomy; Feasibility and safety |
| title_full_unstemmed | Caesarean Myomectomy; Feasibility and safety |
| title_short | Caesarean Myomectomy; Feasibility and safety |
| title_sort | caesarean myomectomy feasibility and safety |
| topic | Caesarean section Myomectomy Fibroids Pregnancy Haemorrhage Oman |
| url | http://web.squ.edu.om/squmj/includes/tng/pub/tNG_download.asp?id=ed151cd7da47e0b8928d231e2e2f0d00 |
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