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The impact of a novel transendometrial approach for caesarean myomectomy on obstetric outcomes of subsequent pregnancy: a longitudinal panel study
Author(s) -
Huang SY,
Shaw SW,
Su SY,
Li WF,
Peng HH,
Cheng PJ
Publication year - 2018
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.14798
Subject(s) - medicine , obstetrics , caesarean section , placental abruption , pregnancy , gestational age , birth weight , premature rupture of membranes , blood transfusion , apgar score , placenta accreta , population , gestation , placenta , fetus , surgery , genetics , biology , environmental health
Objective To evaluate the obstetric and surgical outcomes of a novel transendometrial approach for myomectomy during caesarean section in subsequent pregnancies. Design Longitudinal panel study. Setting Chang Gung Memorial Hospital, Taiwan, with approximately 5000 births per annum. Population Pregnant women complicated with uterine myoma. Method Sixty‐three pregnant women who received transendometrial myomectomy during the first caesarean delivery reported a subsequent live pregnancy and planned an elective repeat caesarean delivery. Main outcome measures Obstetric outcomes consisted of gestational age at birth, newborn weight, Apgar score, birthweight adequacy, uterine rupture, placental abruption, placenta praevia, placenta accreta, spontaneous preterm birth and preterm premature rupture of membranes. Surgical outcomes consisted of surgical time, blood loss, blood transfusion, postoperative fever, length of hospital stay and mean adhesion score. Result The mean gestational age at birth and newborn weight at the subsequent caesarean section were superior to those at the first caesarean delivery. Spontaneous preterm birth, small‐for‐gestational‐age infants and preterm premature rupture of membranes occurred more often in the first pregnancy than in the subsequent pregnancy. The mean surgical time was shorter for the subsequent caesarean delivery than for the first caesarean delivery combined with myomectomy. The other surgical composite outcomes of blood loss, blood transfusion, postoperative fever, length of hospital stay and mean adhesion score were similar across the two stages of caesarean deliveries. Conclusion The novel transendometrial approach for caesarean myomectomy may improve the obstetric outcomes of subsequent pregnancy without causing any additional immediate and long‐term adverse surgical outcomes. Tweetable abstract Transendometrial caesarean myomectomy may improve future obstetric outcomes.