title: Comparative Study of Cesarean Myomectomy with Abdominal Myomectomy in Terms of Blood Loss in Single Fibroid.
abstract: OBJECTIVE
  In this study, we evaluate the safety and feasibility of cesarean myomectomy and compare this procedure with abdominal myomectomy in single fibroid, in terms of blood loss and postoperative complications.
  
  
  METHODS
  Thirty-three patients who underwent cesarean myomectomy from June 2006 to 2012 in Amrita Institute of Medical Sciences, were included in the study. Almost an equal number of patients who underwent abdominal myomectomy (32) in the same period were included. Women are divided into two groups: group 1-cesarean myomectomy, group 2-abdominal myomectomy.
  
  
  RESULTS
  Mean age of the women was comparable; mean gestational age in group 1 was 37.97 +/- 1.57 weeks; and 60 % were primiparous. Hemoglobin (Hb) drop postoperatively was compared between the groups, and there was no significant difference. Though there was statistically significant difference among the groups regarding the size of fibroids, the main outcome measure of the study, the Hb drop was comparable between group 1 and 2. There is statistically significant difference in the Hb difference with increasing mean diameter of the fibroids. As the size increases, Hb drop also increases indicating the increasing blood loss. The measures used to reduce blood loss such as vasopressin instillation and stepwise devascularization influence the blood loss, and P value shows borderline significance. There was no difference in Hb drop among the groups according to the type of fibroids. But more subserous fibroids were removed in group 1, whereas more intramural fibroids were removed in group 2.
  
  
  CONCLUSIONS
  Cesarean myomectomy can be safely done in single fibroids and is comparable to abdominal myomectomy in terms of blood loss.
authors.affiliation: Amrita Institute of Medical Sciences, Ponekkara, Kochi, 682041 India.
authors.forename: Janu Mangala
authors.initials: JM
authors.lastname: Kanthi
authors.affiliation: Amrita Institute of Medical Sciences, Ponekkara, Kochi, 682041 India.
authors.forename: Sudha
authors.initials: S
authors.lastname: Sumathy
authors.affiliation: Amrita Institute of Medical Sciences, Ponekkara, Kochi, 682041 India.
authors.forename: Sarala
authors.initials: S
authors.lastname: Sreedhar
authors.affiliation: Amrita Institute of Medical Sciences, Ponekkara, Kochi, 682041 India.
authors.forename: B
authors.initials: B
authors.lastname: Rajammal
authors.affiliation: Amrita Institute of Medical Sciences, Ponekkara, Kochi, 682041 India.
authors.forename: M G
authors.initials: MG
authors.lastname: Usha
authors.affiliation: Amrita Institute of Medical Sciences, Ponekkara, Kochi, 682041 India.
authors.forename: V S
authors.initials: VS
authors.lastname: Sheejamol
keywords: Abdominal myomectomy; Blood loss; Cesarean myomectomy; Mean diameter of fibroid