Myomectomy during cesarean section
- Authors: Krot I.F.1, Ruhlyada N.N.1, Romanova L.A.1, Reznik V.A.1, Sergienko O.I.1, Chikhladze V.U.1, Vartanyan R.A.1
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Affiliations:
- Saint Petersburg State Pediatric Medical University, Ministry of Health of the Russian Federation
- Issue: No 2 (2024)
- Pages: 72-78
- Section: Original Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/631356
- DOI: https://doi.org/10.18565/aig.2023.262
- ID: 631356
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Abstract
Objective: The purpose of this study was to assess the feasibility of performing myomectomy during cesarean section using different techniques, the effect of extension of surgery on duration of operation, intraoperative blood loss, and the course of the postoperative period.
Materials and methods: The study was conducted at the Department of Pregnancy Pathology, the University Clinic of Saint Petersburg State Pediatric Medical University. The surgical protocols of 377 patients, who delivered babies through cesarean section, and the delivery histories of 69 women with uterine fibroids were investigated. The patients were divided into 2 groups: group 1 consisted of 24 women who underwent myomectomy during cesarean section and group 2 consisted of 45 patients, who did not undergo myomectomy.
Results: Uterine fibroids were diagnosed in 69/377 (18.3%) patients. Myomectomy during cesarean section was performed in 24/377 (6.4%). In 12/24 (50%) women, uterine fibroids were the major indication for surgical delivery. The total number of removed myoma nodules was 39. Most of removed myoma nodules were located on the anterior uterine wall and were divided by fibroid growth into interstitial (type 4), and interstitial-subserous (type 5). Different surgical techniques were used for removal of the nodules: fetal extraction before hysterotomy; in a typical manner; on the uterine cavity side (endometrial myomectomy); transmural route. Duration of operation in group 1 was longer, however, there was no significant difference in the length of fetal extraction and intraoperative blood loss. The newborns in both groups had no signs of hypoxia. Extension of surgery did not lead to postoperative complications.
Conclusion: The results obtained in the study confirm the feasibility of performing myomectomy during cesarean section and safety approach, that helps to improve immediate and long-term treatment results and has significant medical and cost effectiveness.
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About the authors
Irina F. Krot
Saint Petersburg State Pediatric Medical University, Ministry of Health of the Russian Federation
Author for correspondence.
Email: irinakrot@mail.ru
MD, PhD, Obstetrician-Gynecologist
Russian Federation, 194100, St. Petersburg, Litovskaya str., 2Nikolai N. Ruhlyada
Saint Petersburg State Pediatric Medical University, Ministry of Health of the Russian Federation
Email: nickolasr@mail.ru
Dr.Med. Sci.,Professor, Head of the Department of Obstetrics and Gynecology
Russian Federation, 194100, St. Petersburg, Litovskaya str., 2Larisa A. Romanova
Saint Petersburg State Pediatric Medical University, Ministry of Health of the Russian Federation
Email: l_romanova2011@mail.ru
MD, PhD, Associate Professor, Associate Professor at the Department of Neonatology with courses of Neurology and Obstetrics and Gynecology
Russian Federation, 194100, St. Petersburg, Litovskaya str., 2Vitaly A. Reznik
Saint Petersburg State Pediatric Medical University, Ministry of Health of the Russian Federation
Email: klinika.spb@gmail.com
Dr.Med. Sci., Chief Physician of the Children’s Clinical Hospital
Russian Federation, 194100, St. Petersburg, Litovskaya str., 2Olga I. Sergienko
Saint Petersburg State Pediatric Medical University, Ministry of Health of the Russian Federation
Email: lelya.sergienko.80@mail.ru
MD, Head of the Department of Pregnancy Pathology
Russian Federation, 194100, St. Petersburg, Litovskaya str., 2Vano U. Chikhladze
Saint Petersburg State Pediatric Medical University, Ministry of Health of the Russian Federation
Email: komrad.ushangi2010@yandex.ru
MD, Obstetrician-Gynecologist
Russian Federation, 194100, St. Petersburg, Litovskaya str., 2Ruzanna A. Vartanyan
Saint Petersburg State Pediatric Medical University, Ministry of Health of the Russian Federation
Email: ruzannavar@icloud.com
MD, Obstetrician-Gynecologist
Russian Federation, 194100, St. Petersburg, Litovskaya str., 2References
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