How Unsafe is Myomectomy at Caesarean Section?

Objective: To provide evidence on the safety or otherwise of the practice of myomectomy during Caesarean section.Methods: This was a prospective, randomized, case controlled study conducted at the Obio Cottage Hospital, Port Harcourt, Nigeria, between November 2011 and October 2012. 42 Caesarean section patients, who also had myomectomy, were compared with those who had Caesarean section alone. The Caesarean myomectomy cases also had the number, location and size of the fibroids removed analyzed.Results: 446 women were delivered by Caesarean section and 42 of these had Caesarean myomectomy. The mean ages were similar. Between 1 and 23, uterine fibroids were removed. The mean blood loss from the Caesarean myomectomy and Caesarean section was 584.72 and 695.71mls respectively. There was no statistical difference in the blood loss, Hematocrit deficit and length of hospital stay (p values of 0.053, 0.299 and 0.334 respectively) while the duration of surgery and number of sutures used were statistically different between the two groups (p value < 0.001 in both). The post-operative complications were similar.Conclusions: This study found that Caesarean myomectomy is a safe procedure in experienced hands and has obvious advantages to the patient.Keywords: Caesarean section, Myomectomy, Blood loss, Port Harcourt