Brown, D.; Fletcher, Horace M.; Myrie, M.; Reid, Marvin E.
Author Affiliation, Ana.
Department of Obstetrics, Gynaecology and Child Health
Caesarean myomectomy a safe procedure: Retrospective case controlled study
Journal of Obstetrics and Gynaecology
Date of Publication
Sixteen women, with uterine fibroids in pregnancy, who were treated by caesarean myomectomy, were compared retrospectively with 16 women, without uterine fobroids who had caesarean section during the same period. Myomectomy was performed at caesarean section after delivery of the baby and the placenta, with the adminstration of intravenous oxytocin. The fibroid defects were occluded with continuous interlocking and fixted sutures. Routine caesarean section was performed on the subjects in the control groups. The comparative efficacy of the procedure was measured by comparing pre-and post-operative haemoblobin levels, measured blood loss, need for blood transfusion, post-operative febrile morbidity and length of hospital stay in both groups. Caesarean myomectomy resulted in a mean blood loss of 495 ml (range 200-1000 ml) compared with 355 ml (range 150-900 ml) in the control group (P=0.0907). The caesarean myomectomy group had a mean fall of 1.4g/dl in the control group. Ther were no significant differences between the groups in the need for blood transfusion, post-operative febrile morbidity or length of hospital stay. The results indicate that casarean myomectomy is safe and offers no significant increased risk to the patient over caesarean section alone. This is beneficial to the health sector by the avoidance of an interval myomectomy hence justifying the cost effectiveness of the procedure.....