Safety of Cesarean Myomectomy: A Case Series from Sudan

Background: Uterine fibroids are benign tumors common among women of reproductive age.While cesarean myomectomy is often avoided due to potential complications, advances in surgical techniques and perioperative care have made it a viable option.This study evaluates the safety and outcomes of cesarean myomectomy, focusing on intraoperative, postoperative and reproductive outcomes among women in the Red Sea State, Sudan.Methods: A retrospective study was conducted on 120 women who underwent cesarean myomectomy at Port Sudan Maternity Hospital from 2014 to 2022.Demographic, clinical, obstetric and perinatal data were collected and analyzed.Intraoperative and postoperative outcomes, including blood loss, pain levels, hospital stay duration and subsequent pregnancy rates, were assessed.Statistical analyses, including logistic regression and chi-square tests, were used to identify factors influencing these outcomes. Results:The mean age of the participants was 28 years, with the majority being primigravida.Each patient had an average of 2 fibroids, with intramural fibroids being the most common type (66.7%).Nearly all surgeries were completed with blood loss between 250-500 mL and only one patient required a transfusion.No cases of hysterectomy or surgical reopening occurred.Postoperative pain was mostly mild (58.3%), with moderate pain reported by 41.7% of patients.Most patients (64.2%) were discharged within two days and 60% of the participants successfully conceived following the procedure.Logistic regression showed that having multiple fibroid types or more than two fibroids increased the likelihood of longer hospital stays, while chi-square tests revealed a significant association between the number of fibroids and postoperative pain. Conclusion:Cesarean myomectomy is a safe procedure with minimal complications and favorable reproductive outcomes in appropriately selected patients.While factors like fibroid number and type influence postoperative recovery and pain levels, the procedure offers a viable option for managing fibroids during cesarean delivery, reducing the need for future surgeries.