title: Myomectomy for intramural fibroids during caesarean section: A therapeutic dilemma.
abstract: The aim of the present study was to assess the safety of myomectomy for intramural fibroids during caesarean section. A retrospective study of 63 women who underwent myomectomy during caesarean section and 63 women who underwent caesarean delivery without myomectomy was conducted. The study group was divided into subgroups according to the volume of fibroids and total incision count. The volume of fibroids, the preoperative and postoperative haemoglobin values and the difference between them, incidence of haemorrhage and blood transfusion, duration of operation and postoperative fever of patients were investigated. Duration of operation was longer (p < .001) and haemoglobin loss was higher (p = .01) in the myomectomy group. There was no difference between one incision and two incisions subgroups in terms of mean haemoglobin change (p = .068). Haemoglobin loss was higher in volume >50 cm3group than volume <50 cm3and control groups. These differences were statistically significant (p = .02; p = .001, respectively). Although intramural fibroids can be safely removed during caesarean section, large fibroids and extra incisions for myomectomy are risk factors for haemorrhage.
authors.affiliation: a Obstetrics and Gynaecology Department , Okmeydani Training and Research Hospital , Istanbul , Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Akbas
authors.affiliation: a Obstetrics and Gynaecology Department , Okmeydani Training and Research Hospital , Istanbul , Turkey.
authors.forename: Veli
authors.initials: V
authors.lastname: Mihmanli
authors.affiliation: a Obstetrics and Gynaecology Department , Okmeydani Training and Research Hospital , Istanbul , Turkey.
authors.forename: Berk
authors.initials: B
authors.lastname: Bulut
authors.affiliation: a Obstetrics and Gynaecology Department , Okmeydani Training and Research Hospital , Istanbul , Turkey.
authors.forename: Ilkbal
authors.initials: I
authors.lastname: Temel Yuksel
authors.affiliation: a Obstetrics and Gynaecology Department , Okmeydani Training and Research Hospital , Istanbul , Turkey.
authors.forename: Gulsen
authors.initials: G
authors.lastname: Karahisar
authors.affiliation: a Obstetrics and Gynaecology Department , Okmeydani Training and Research Hospital , Istanbul , Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Demirayak
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D001803:Blood Transfusion / Q000706:statistics & numerical data; D016022:Case-Control Studies; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000601:surgery*; D061646:Operative Time; D011184:Postoperative Period; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D063186:Uterine Myomectomy / Q000379:methods*; D014594:Uterine Neoplasms / Q000601:surgery*
keywords: cesarean section; fibroid; myomectomy