Myomectomy during cesarean section.

摘要

OBJECTIVE: To evaluate the safety and effectiveness of myomectomy during cesarean section (CS). Design. Retrospective case-control study. SETTING: Tertiary referral university hospital. POPULATION AND METHODS: A study group of 1,242 pregnant women with fibromyomas who underwent myomectomy during CS and three control groups of 200 matched pregnant women without fibromyomas who underwent CS deliveries (Group A), 145 patients with fibromyomas who underwent CS deliveries without removal of fibromyomas (Group B) and 51 patients with fibromyomas who had a hysterectomy during CS (Group C). MAIN OUTCOME MEASURES: The difference between pre- and postoperative hemoglobin levels, the incidence of hemorrhage, blood transfusion, postoperative fever, duration of operation and length of hospital stay. RESULTS: No difference was found in the median parity or mean gestational age, but maternal age was higher and the gestational age lower in Group C than the study group. The median number and diameter of fibromyomas in Group B were lower than in the study group. Compared to the study group, Group B women had more single fibromyomas, while those in Group C had more multiple fibromyomas. Group B had more uterine cornual fibromyomas than the study group. There were no differences in the mean hemoglobin change, the incidence of postoperative fever and the length of hospital stay among groups. CONCLUSION: Myomectomy during CS was a safe and an effective procedure.