Evaluation of Myomectomy During Cesarean Section

Background: Uterine leiomyomas, also known as myomas or fibroids, represent the most frequent benign tumors occurring in the female reproductive system. Presently, there is a lack of international agreement regarding the necessity of conducting myomectomies during cesarean sections (CS). The increased detection of uterine fibroids is partly due to advances in imaging modalities such as transvaginal ultrasound and MRI, as well as delayed childbearing associated with modern lifestyle and fertility trends. Aim: The objective of this study is to assess the immediate surgical outcomes and short-term postoperative results of performing myomectomy during cesarean sections (CS). Patients and methods: This study is a prospective interventional single-arm clinical trial involving 52 pregnant women with myomas undergoing CS. A comprehensive assessment of medical, gynecological, and obstetric history was conducted. Both general and local examinations were performed. All participants underwent transabdominal ultrasonography to evaluate the fetus and examine the myoma. Subsequently, all women underwent myomectomy during the cesarean section. Results: Our study included a total of 52 patients, with the average age of the participants being 33.59 years. In terms of fibroid characteristics, the majority of patients presented with multiple myomas (57.69%). On average, the number of detected myomas per patient was 1.96 ± 0.9, ranging from one to three. The average duration of the surgical procedure was 69.03 ± 12.68 minutes, varying from 45 to 90 minutes. Intraoperative blood loss ranged from 600 to 1300 ml, with an average of 924.038 ± 195.9 ml. Blood transfusion was administered to four patients (7.69%). No organ damage occurred during the study, and none of the patients required internal iliac ligation or hysterectomy. Conclusion: Performing a myomectomy during a cesarean section seems to be a safe procedure. It not only eliminates the necessity for additional surgeries but also comes with reasonable rates of complications.