Myomectomy at Cesarean Section: Practical Aspects

Introduction: Fibroids are the most common benign tumors of uterus. Fibroids in pregnancy can lead to adverse maternal and fetal outcomes. Their incidence in pregnancy has been notified as 2-5%. Objective: The objective of this study was to assess and compare the feto-maternal outcome of the pregnant patients, complicated by fibroid uterus, with cesarean myomectomy done and cesarean section only done. Materials and Methods: This is a prospective comparative study conducted in the department of Obstetrics and Gynecology, SKIMS SOURA, Jammu and Kashmir, India, from September 2021 to September 2024. A prospective evaluation of 160 patients having fibroids has been done. Maternal age, parity, size of fibroid, number of fibroid, type of fibroid was noted. Out of 160 patients, cesarean myomectomy was done in 80 (cases), and simple cesarean section was done in 80 (controls). Maternal outcome in the form of intraoperative blood loss, need of blood transfusion both intra-operative and post-operative, increase in operative time, fall in hemoglobin, and Apgar score, was studied and results were compared. Results: In our study, no significant difference in intraoperative blood loss (514±50ml vs 450±48ml) was found. No significant difference in need of intra-operative or post-operative blood transfusion was found (3.75% vs 2.5%). The operative period was slightly higher in cases compared to control (55±5 min vs 45±4min; P