Myomectomy for fibroids during cesarean section: A randomized controlled trial

Abstract

Background: There is a considerable debate about the management of myoma during cesarean section (CS). Recently, several studies indicated the safety and feasibility of undertaking myomectomy during CS.
Objectives: To evaluate the safety, accessibility, and short-term morbidity of myomectomy for fibroids during cesarean section.
Patients and Methods: This was a randomized controlled trial that included 72 patients who were admitted to the Obstetrics & Gynecology Department, Menoufia University Hospital with uterine fibroids during pregnancy; who were randomly allocated equally into a group of cesarean myomectomy (CM; n=36) and another group of CS only (n=36). The operative events and the outcome were recorded and analyzed.
Results: CM group showed a longer duration of surgery and longer hospital stay, higher amount of blood loss, and higher mean pain sores, with a highly statistically significant difference (p = 0.000). No cases in both groups required blood transfusion or ICU admission. No statistically significant differences were noted between both groups as regards the fetal outcome measures (p=0.583 & 0.601).
Conclusion: CM is safe and applicable in selected cases without deleterious maternal complications. Special precautions ought to be paid during the procedure, particularly in the intramural type and with large fibroids.