Is myomectomy safe during cesarean section in large myomas?

Objective: The rate of cesarean section, gravida and pregnancy age have been gradually increasing. Thus the rate of myoma have increased during cesarean. But it may difficult to make decision aboiut myomectomy during cesarean especially large myomas because of complications. Therefore, several obstetricians do not recommend cesarean myomectomy, except in cases of small and pedunculated uterine fibroids that do not result in complications. The aim of this study to evaluate safety of myomectomy during emergency cesarean section in large myomas.  Material and Methods: We examined retrospectively the results of 190 patients who underwent cesarean myomectomy in two non tertiary hospital in southeastern Anatolia. We compared complications, hemoglobin change, length  of stay in hospital and blood transfusion according to diameter of myoma. Complication and blood transfusion rates in relation to the diameter of uterine fibroids were evaluated using Fisher’s exact test. Changes in hemoglobin levels from baseline value and length of stay in hospital were compared using the Mann Whitney U test. Significance level was set at P <0.01 and 0.05. Results: No significant association was found between complication rates and diameter of the fibroids ( P =0.633). Similarly, no significant association was observed between the type of uterine fibroids and complication rates ( P =1.000). We also found no significant difference among the changes in hemoglobin levels, length of stay in hospital and transfusion ( P =0.835, p=0.184, p=0.633).  Conclusion: Myomectomy is safe procedure at the emergency cesarean section in large myoma with attention.