RETHINKING CAESAREAN MYOMECTOMY: OLD TEACHINGS AND NEW EVIDENCE SUPPORTING BETTER OUTCOMES

Introduction Fibroids are the most common benign tumours of the female reproductive tract in women of childbearing age and their incidence is increasing. The successes reported in multiple cases of caesarean myomectomies have shifted the debate on the benefits of this procedure. Case presentation We present a 37-year-old woman who successfully underwent a caesarean myomectomy at term. She had postpartum haemorrhage which was corrected with blood transfusion and managed with uterotonics and haemostatic techniques. Conclusion Caesarean myomectomy in carefully selected patients has been associated with good outcomes and reduces the need for a second surgery. This is however not a routine procedure and can be associated with serious adverse maternal outcomes in poorly selected patients, inexperienced surgeons and where there is limited haemostatic resources.