Our Summary

This research was aimed at looking at the link between having a type of surgery called a myomectomy (which involves removing fibroids from the uterus) and how this affects childbirth. The study looked at two groups of women giving birth: those who had previously had a myomectomy, and those who hadn’t.

The study found that women who had had a myomectomy were less likely to go into labor naturally, and more likely to need an emergency cesarean section. This was often due to concerns about the uterus rupturing, although no actual ruptures or baby deaths occurred. It also took these women longer to get through the first stage of labor.

However, the study found no difference between the two groups in terms of how long the later stages of labor took, whether they bled excessively after giving birth, experienced vaginal tearing, or had babies with health problems.

In simple terms, having had a myomectomy could increase the chances of needing an emergency cesarean section, but it doesn’t seem to increase the risk of other complications during childbirth.

FAQs

  1. What is a myomectomy and how does it affect childbirth?
  2. Does having a myomectomy increase the likelihood of needing an emergency cesarean section?
  3. Does a myomectomy affect the later stages of labor and postpartum complications?

Doctor’s Tip

One helpful tip a doctor might tell a patient about myomectomy is to discuss with their obstetrician or midwife about their previous surgery and any potential risks or complications that may arise during childbirth. It is important for women who have had a myomectomy to have a comprehensive birth plan in place and to be closely monitored throughout their pregnancy and labor to ensure the best possible outcome for both mother and baby. It is also important for women to communicate any concerns or symptoms they may be experiencing with their healthcare provider to address them promptly.

Suitable For

Patients who are typically recommended myomectomy are those who have symptomatic fibroids that are causing significant pain, heavy bleeding, or fertility issues. Myomectomy is often recommended for women who wish to preserve their fertility and have fibroids that are affecting their ability to conceive or carry a pregnancy to term. Additionally, myomectomy may be recommended for women who have fibroids that are causing complications during pregnancy, such as increased risk of miscarriage or preterm labor. It is important for patients to discuss their individual circumstances with their healthcare provider to determine if a myomectomy is the best treatment option for them.

Timeline

Before a myomectomy:

  • Patient may experience symptoms of fibroids such as heavy menstrual bleeding, pelvic pain, frequent urination, or difficulty getting pregnant
  • Patient undergoes diagnostic tests such as ultrasound or MRI to confirm the presence of fibroids
  • Patient discusses treatment options with their healthcare provider, including the possibility of a myomectomy

After a myomectomy:

  • Patient undergoes the surgical procedure to remove fibroids from the uterus
  • Patient may experience pain, discomfort, and fatigue after the surgery
  • Patient is monitored for any complications such as infection or excessive bleeding
  • Patient may need to take pain medication and follow-up with their healthcare provider for post-operative care
  • Patient may experience improvements in symptoms such as reduced menstrual bleeding, relief from pelvic pain, and increased fertility potential

Overall, a myomectomy can provide relief from symptoms caused by fibroids and improve a patient’s quality of life, but it is important to discuss the potential risks and benefits with a healthcare provider before undergoing this procedure.

What to Ask Your Doctor

Some questions a patient should ask their doctor about myomectomy in relation to childbirth include:

  1. What are the potential risks or complications of having a myomectomy before childbirth?
  2. Will having had a myomectomy affect my chances of going into labor naturally?
  3. What are the chances of needing an emergency cesarean section if I have had a myomectomy?
  4. Are there any specific precautions or considerations I should be aware of during pregnancy and childbirth if I have had a myomectomy?
  5. How will having had a myomectomy impact the duration of labor and delivery?
  6. Are there any steps I can take to reduce the likelihood of needing an emergency cesarean section if I have had a myomectomy?
  7. Will I need any additional monitoring or care during pregnancy and childbirth due to having had a myomectomy?
  8. Are there any specific factors related to my individual case that may affect how myomectomy could impact childbirth for me?
  9. What are the long-term effects of having had a myomectomy on future pregnancies and childbirth?
  10. Are there any alternative treatment options or strategies that could potentially mitigate the risks associated with having had a myomectomy before childbirth?

Reference

Authors: La Verde M, Cobellis L, Torella M, Morlando M, Riemma G, Schiattarella A, Conte A, Ambrosio D, Colacurci N, De Franciscis P. Journal: J Invest Surg. 2022 Jan;35(1):126-131. doi: 10.1080/08941939.2020.1836289. Epub 2020 Oct 26. PMID: 33100090