title: [Is vaginal delivery possible for patients with myomectomy? Results of a monocentric study].
abstract: OBJECTIVE
  To compare delivery outcomes according to the scar: myomectomy versus low-segment transverse cesarean.
  
  
  METHODS
  A retrospective cohort study was performed in a university type 3 service between 1st January 2006 and 1st January 2012. We compared 18 women who gave birth after myomectomy (exposed group) to 72 women who gave birth after cesarean section (non-exposed group). Women younger than 43 years who underwent laparotomy or laparoscopic myomectomy were included. The primary endpoint was the rate of vaginal delivery. The route of delivery, the rate of uterine rupture, complications of delivery and neonatal outcome were studied.
  
  
  RESULTS
  The acceptance rate of vaginal delivery was 55.6% after myomectomies versus 84.7% after cesarean section (P=0.005). The success of vaginal birth was 88.9% after myomectomy versus 73.9% after cesarean (NS). No uterine rupture has occurred after myomectomy against three sub-peritoneal rupture after cesarean. The occurrence of post-partum hemorrhage was not significantly different between the 2 groups (11.1% among exposed group versus 6.9% in the non-exposed group). The cesarean section rate was even higher than the number of hysterotomy was great (P=0.0047).
  
  
  CONCLUSIONS
  This study seems to show that vaginal birth after myomectomy is possible with a success rate similar to vaginal birth after cesarean section.
authors.affiliation: Département d'obstétrique, gynécologie et médecine de la reproduction, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France; Université de Caen, 14000 Basse-Normandie, France. Electronic address: anne_villot@yahoo.fr.
authors.forename: A
authors.initials: A
authors.lastname: Villot
authors.affiliation: Département d'obstétrique, gynécologie et médecine de la reproduction, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France.
authors.forename: A
authors.initials: A
authors.lastname: Cheret-Benoist
authors.affiliation: Université de Caen, 14000 Basse-Normandie, France; Département de statistiques médicales, CHU de Caen, avenue Clémenceau, 14033 Caen, France.
authors.forename: C
authors.initials: C
authors.lastname: Creveuil
authors.affiliation: Département d'obstétrique, gynécologie et médecine de la reproduction, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Turck
authors.affiliation: Département d'obstétrique, gynécologie et médecine de la reproduction, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France; Université de Caen, 14000 Basse-Normandie, France.
authors.forename: M
authors.initials: M
authors.lastname: Dreyfus
authors.affiliation: Département d'obstétrique, gynécologie et médecine de la reproduction, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France; Université de Caen, 14000 Basse-Normandie, France.
authors.forename: G
authors.initials: G
authors.lastname: Benoist
mesh_terms: D000328:Adult; D002585:Cesarean Section; D002921:Cicatrix; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D063186:Uterine Myomectomy / Q000009:adverse effects* / Q000379:methods; D014597:Uterine Rupture / Q000453:epidemiology; D016064:Vaginal Birth after Cesarean / Q000706:statistics & numerical data
keywords: Accouchement; Hémorragie du post-partum; Myomectomie; Myomectomy; Post-partum hemorrhage; Prior cesarean; Rupture utérine; Tentative de voie basse; Trial of labor; Uterine rupture; Utérus cicatriciel; Vaginal birth