Unavoidable Caesarian Myomectomy In A Case Of Transverse Lie With Huge Fibroid At Incision

Abstract

Myomectomy during caesarean delivery may lead to hemorrhage and uterine atony ,hence it is not recommended. Myomectomy has been reported during cesarean section in recent studies. We presented a patient who was 30 yr old, primigravida with 40wks gestation with transverse lie in prelabour, taken for emergency lower segment caesarian section, and was accidentally found to have a huge myoma in the incision site. As uterine incision could not be closed because of the myoma, myomectomy was performed during caesarean section unavoidably. A single 760 g and 9 cmx 7 cm sized and another fibroid of 4cm x3cm myoma was removed. The physical examinations were unremarkable in the postoperative period. If myomectomy during caesarean delivery becomes a widespread practice, it could potentially eliminate multiple surgeries for both indications. Many surgeons have been reluctant to adopt this policy without conclusive evidence demonstrating its safety. However, most of the authors suggested that the complications and morbidity following caesarean myomectomy do not significantly differ from those occurring during caesarean section alone, while fertility is apparently not compromised by this treatment.