2022 Volume 58 Issue 1 Pages 76-82
Myomectomy during cesarean section is still controversial because of the potential risk for uncontrolled bleeding. The aim of this study was to clarify the safety of uterine myomectomy during cesarean section. We classified 25 patients who underwent cesarean myomectomy into four groups according to the location of myoma （subserosal + intramural, subserosal, intramural, and cervical）. The maximum length and number of enucleated myomas, operation time, blood loss, intraoperative blood transfusion volume, change in hemoglobin concentration （pre-operative level to lowest post-operative level）, length of hospital stay after surgery and complications were retrospectively compared among four groups. The cervical group tended to have higher blood loss, hemoglobin changes, autologous blood return, and longer days in postoperative hospital stay than the other groups, but these differences were not significant. There were no serious complications associated with cesarean myomectomy including a case in which myomectomy was also performed at 13 weeks’ gestation. Myomectomy during cesarean section can be safely performed with a proper selection of patients, sufficient preoperative preparations such as autologous and intraoperative strategies to avoid massive blood loss.
