Safety and feasibility of myomectomy during caesarean section in case of pregnancy associated with fibroid uterus

Routine myomectomy during pregnancy is not recommended because of excessive bleeding during myomectomy and the difficulty in securing hemostasis may need hysterectomy. This prospective observational study was carried out in Obstetrics & Gynecology department of Ad-din Akij Medical College, Khulna from June 2016 to August 2017 to evaluate safety and feasibility of performing myomectomy at the time of caesarean delivery. Nineteen patients with fibroid uterus with pregnancy whom needed cesarean section for various indications were the target population for this study. Main outcome measures were difficulty of myomectomy & cesarean section, time needed for operation, per-operative complications, need for blood transfusion, postoperative complications and duration of hospital stay. Caesarean myomectomy operation was successful in all cases. No patient was required hysterectomy. The duration of operation was 45-60 minutes. Only one patient had one unit of whole blood transfusion during postoperative period. Mean (SD) duration of hospital stay and post-operative Hb concentration were 6.9 (0.6) days and 8.6 (1.4) g/dl, respectively. Two patients developed post-operative fever which delayed their hospital stay. Myomectomy during cesarean section in selected cases with proper indication is safe and feasible. Mediscope Vol. 5, No. 1: Jan 2018, Page 5-9