Ayse Nur Aksoy, Kemal Tolga Saracoglu, Mehmet Aksoy, Ayten Saracoglu
DOI: 10.4236/health.2011.33029   PDF    HTML     6,567 Downloads   12,040 Views   Citations

Abstract

Since myomectomy throughout cesarean deliv- ery may lead to hemorrhage and uterinal atony, it is not recommended. But, myomectomy has been reported during cesarean section in recent studies. We presented a patient with large in- tramural myoma who was diagnosed at 34 weeks of pregnancy and operated with an unavoidable cesarean-combined myomectomy. A 33-year-old unpursued primigravida was referred to emer- gency department with abdominal pain and amenorrhea of 34 weeks duration. A sonographic diagnosis of myoma in pregnancy was made. Cesarean section was required for fetal distress and alive 2300 g weighted male infant with Ap- gar score of 6 at one minute, was born. As uterine incision could not be closed because of the myoma, myomectomy was performed dur- ing cesarean section unavoidably. A single 970 g and 15 × 18 cm sized myoma was removed. The physical examinations were unremarkable in the postoperative period. Although there are case series that have demonstrated the safety of myomectomy during cesarean section, we con-cluded that myomectomy during cesarean section is not a safe procedure accept inevitable situa-tions.

Keywords

Pregnancy; Cesarean Section; Myoma

Share and Cite:

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Scott, J.R., Disaia, P.J., Hammond, C.B. and Spellacy, W.N. (1997) Danforth’s Obstetrics and Gynecology. In: Creasman TW. Disorders of uterine corpus. 7th Edition, Lippincott-Raven Publishers, New York, 925-939.
[2]	Ortac, F., Gungor, M. and Sonmezer, M. (1999) Myomectomy during cesarean section. International Journal of Gynecology & Obstetrics, 67, 189-190. . doi:10.1016/S0020-7292(99)00129-0
[3]	Davis, J.L., Ray-Mazumder, S., Hobel, C.J., Baley, K. and Sassoon, D. (1990) Uterine leimyomas in pregnancy: A prospective study. Obstetrics & Gynecology, 75, 41-44.
[4]	Hasan, F., Arumugam, K. and Sivanesaratnam, V. (1990) Uterine leimyomata in pregnancy. Int J Gynecol Obstet, 34, , 45-48. doi:10.1016/0020-7292(91)90537-F
[5]	Kwawukume, E.Y. (2002) Myomectomy during cesarean section. International Journal of Gynecology & Obstet-rics, 76, 183-184. doi:10.1016/S0020-7292(01)00586-0
[6]	Burton, C.A., Grimes, D.A. and March, C.M. (1989) Surgical management of leimyomata during pregnancy. Obstetrics & Gynecology, 74, 707-709.
[7]	Roman, A.S. and Tabsh, K.M.A (2004) Myomectomy at time of cesarean delivery: A retrospective cohort study. BMC Pregnancy Childbirth, 16, 14-17. doi:10.1186/1471-2393-4-14
[8]	Bhatla, N., Dash, B.B., Kriplani, A. and Aqarval, N. (2009) Myomectomy during pregnancy: A feasible option. Journal of Obstetrics and Gynaecology Research, 35, 173-175. doi:10.1111/j.1447-0756.2008.00873.x
[9]	Li, H., Du, J., Jin, L., Shi, Z. and Liu, M. (2009) Myomectomy during cesarean section. Acta Obstetricia et Gynecologica Scandinavica, 88, 183-186. doi:10.1080/00016340802635526
[10]	Adesiyun, A.G., Ojabo, A. and Durosinlorun, M.A. (2008) Fertility and obstetric outcome after caesarean myo- mectomy. Journal of Obstetrics and Gynaecology, 28, 710-712. doi:10.1080/01443610802462712
[11]	Hass?akos, D., Christopoulos, P., Vitoratos, N., Xarchoulakou, E., Vaggos, G. and Papadias, K. (2006) Myomectomy during Cesarean Section: A Safe Procedure? Annals of the New York Academy of Sciences, 1092, 408-413. doi:10.1196/annals.1365.038
[12]	Kaymak, O., Ustunyurt, E., Okyay, R.E., Kalyoncu, S. and Mollamahmutoglu, L. (2005) Myomectomy during cesarean section. International Journal of Gynecology & Obstetrics, 89, 90-93. doi:10.1016/j.ijgo.2004.12.035