Introduction. Uterine fibroids are the most common pelvic tumours in women. Uterine fibroids are common in women over the age of 30, and their growth is directly related to high levels of circulating estrogens. The frequency of leiomyomas in pregnant women ranges from 0.1% to 3.9%. The exact incidence of uterine fibroids during pregnancy is unknown, but they are known to be associated with multiple maternal and fetal complications. Complications during pregnancy and childbirth occur almost twice as often in women diagnosed with uterine fibroids than in those without. Myomectomy during cesarean section (CS) is not a life-threatening operation as it was believed in the past.
Case presentation. We present a myomectomy during an emergency cesarean section in a 39-year-old patient in her first pregnancy in 28 g.w. The patient was hospitalized urgently due to signs of preterm labor. The attempts to stop the progression of labor were unsuccessful and an emergency surgical delivery was performed. During CS multiple myomatosis of the uterus, with intramural and subserous fibroids, was diagnosed. In cases of subserous myoma on a pedicle, myomectomy is relatively easy, especially if the pedicle is narrowly based. Removal of intramural fibroids is an inadvisable and contraindicated procedure during CS.
Conclusions. Data in the literature are conflicting regarding myomectomy during cesarean delivery. The surgeon must decide whether myomectomy is really indicated at the time of CS or whether it can be delayed for several months after delivery.
Keywords: myomectomy, complications, approaches, cesarean section
Full text sources https://doi.org/10.31688/ABMU.2024.59.2.12
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Elis ISMAIL
Health care Department-Shumen, Medical University Varna, Bulgaria
Address: 150 Tzar Osvoboditel Bul., 9000 Varna, Bulgaria
Email: elis.ismail@mu-varna.bg
