title: Myomectomy during cesarean delivery.
abstract: BACKGROUND
  The optimal management of leiomyomas during cesarean delivery is unclear.
  
  
  OBJECTIVE
  To assess the safety of myomectomy performed during cesarean delivery.
  
  
  METHODS
  PubMed, MEDLINE, EMBASE, and Cochrane Library were searched to identify potentially relevant studies published prior to June 30, 2012.
  
  
  METHODS
  Case-control study comparing myomectomy with no myomectomy in patients undergoing cesarean delivery.
  
  
  METHODS
  The quality of the studies was assessed and data were extracted independently by 2 authors.
  
  
  RESULTS
  Nine studies, including 1 082 women with leiomyomas, met the inclusion criteria; 443 (41.0%) women underwent cesarean myomectomy and 639 (59.1%) underwent cesarean delivery alone. The drop in hemoglobin after surgery was 0.30 g/dL greater in the cesarean myomectomy group than in the control group, but the difference was not significant. The operative time was 4.94 minutes longer in the cesarean myomectomy group, but again the difference was not significant. The overall incidence of fever was comparable in the 2 groups. No hysterectomies were performed in any of the included studies.
  
  
  CONCLUSIONS
  Cesarean myomectomy may be a reasonable option for some women with leiomyoma. However, no definite conclusion can be drawn because the data included in the meta-analysis were of low quality.
authors.affiliation: Department of Obstetrics and Gynecology, Second Affiliated Hospital of Tianjin, University of Traditional Chinese Medicine, Tianjin, China. songdr58@126.com
authors.forename: Dianrong
authors.initials: D
authors.lastname: Song
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Mark C
authors.initials: MC
authors.lastname: Chames
authors.forename: Jie
authors.initials: J
authors.lastname: Guo
mesh_terms: D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000601:surgery*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000601:surgery; D013997:Time Factors; D063186:Uterine Myomectomy / Q000379:methods*; D014594:Uterine Neoplasms / Q000601:surgery