Short and long-term results of cesarean myomectomy Mehmet Ozgur Akkurt, And Yavuz, Serenat Eris, Ozerk T. Turan, Mekin Sezik Suleyman Demirel University, Department of Perinatology Unıversity of Miami, College of Arts and Sciences

Cesarean myomectomy Most obstetricians hesitate to remove uterine fibroid during cesarean section due to increased risk of severe postpartum hemorrhage and associated hysterectomy. According to short-term results, recent studies showed the safety of CM with a slightly increased operation time.

Aim However, long term results of CM is scarce. Therefore, we aimed to investigate long-term results including subsequent pregnancy, fibroid recurrence and adhesion formation during subsequent operation. 91 women underwent cesarean myomectomy included study and followed up for a mean duration of 6.3 ± 1.0 years.

Method

Short-term results There were no differences among the CM (n= 91) and control groups (n=60) in terms of mean change in hemoglobin and hematocrit levels, hemorrhage, as well as requirement for blood transfusions with a slightly increased operative time. Multiple myomas and cervical and cornual localization were associated with an increased drop of hemoglobin and hematocrit (p<0.05).

Short-term results

Short term results in terms of subgroups

Long-term results Recurrence was identified in 5 of the nonpregnant (5.5%) women, and 3 of these (4.1%) underwent an additional major surgery. There was no recurrence in following pregnancies. Subsequent pregnancy rate was 35% (32/91). Preterm delivery (n=1, 3.1%), uterine dehiscence (n=1, 3.1%), placenta previa (n=1, 3.1%), and mild to severe post- CM adhesions (n=8, 25%) were observed in subsequent pregnancies.

Long-term results

Conclusion The recurrence of myoma was relatively low following CM. Subsequent pregnancy is protective for recurrence of myoma without increased adhesion formation and severe obstetric complications. However, the association between placental implantation abnormalities and CM is a concern and prospective studies are needed to evaluate this association.

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