Our Summary

This research paper examines the impact of uterine fibroids (non-cancerous growths in the uterus) on pregnant women. These fibroids can cause complications during pregnancy, and are found in 2-10% of pregnant women. The study looks at the outcomes and risks associated with myomectomy, a surgical procedure to remove these fibroids, during pregnancy.

The researchers looked at various data sources and found 54 articles involving 97 patients who had the procedure. In most cases, the fibroids were removed because they were causing abdominal pain that couldn’t be managed with medication.

The study found that the majority of surgeries were done through a large incision in the abdomen, but some were done laparoscopically (through small incisions using a camera) or vaginally. The surgery usually took about 53 minutes and most patients had only one fibroid removed.

The removed fibroids often showed signs of tissue death and decay. However, in most cases, the pregnancy outcomes were favorable and there were few complications reported.

In conclusion, the data suggests that removing fibroids during pregnancy appears to be safe for women who have symptoms that can’t be managed with other treatments. However, patients should be fully informed about the possible risks.

FAQs

  1. What is a myomectomy and why is it performed during pregnancy?
  2. What are the different methods of performing a myomectomy and how long does the procedure usually take?
  3. According to the research, what are the outcomes and potential risks of having a myomectomy during pregnancy?

Doctor’s Tip

A doctor might advise a patient undergoing myomectomy to follow post-operative care instructions carefully, including avoiding heavy lifting or strenuous activity for a certain period of time to ensure proper healing. They may also recommend regular follow-up appointments to monitor recovery progress and address any concerns. Additionally, they may suggest maintaining a healthy lifestyle and managing stress to promote overall well-being during the healing process.

Suitable For

Patients who are typically recommended myomectomy are those who have symptomatic fibroids that are causing significant pain or discomfort and cannot be managed with medication. Additionally, patients who are experiencing complications during pregnancy due to fibroids may also be recommended for myomectomy. It is important for patients to discuss their individual case with their healthcare provider to determine if myomectomy is the best course of action for them.

Timeline

Before myomectomy:

  1. Patient experiences symptoms such as heavy menstrual bleeding, pelvic pain, and pressure on the bladder or bowel due to uterine fibroids.
  2. Patient consults with a healthcare provider and undergoes diagnostic tests to confirm the presence of fibroids.
  3. Patient discusses treatment options with their healthcare provider, including medication, minimally invasive procedures, or myomectomy.
  4. Patient decides to undergo myomectomy due to persistent symptoms that are not relieved by other treatments.

After myomectomy:

  1. Patient undergoes pre-operative testing and preparation for surgery.
  2. Myomectomy is performed to remove the fibroids from the uterus, either through a large abdominal incision, laparoscopically, or vaginally.
  3. Patient recovers in the hospital for a few days post-surgery, and is monitored for any complications.
  4. Patient may experience some pain, discomfort, and bleeding as they recover from the surgery.
  5. Patient follows post-operative instructions provided by their healthcare provider, including restrictions on physical activity and follow-up appointments.
  6. Patient experiences relief from symptoms such as heavy menstrual bleeding and pelvic pain following the removal of the fibroids.
  7. Patient may undergo further testing to monitor the growth of any remaining fibroids and to assess their fertility and pregnancy potential.
  8. Patient may consider fertility treatments if they are trying to conceive after myomectomy.

What to Ask Your Doctor

Some questions a patient should ask their doctor about myomectomy during pregnancy include:

  1. What are the risks associated with undergoing a myomectomy during pregnancy?
  2. How will the procedure affect my pregnancy and the health of my baby?
  3. What are the potential complications of the surgery?
  4. How long will the recovery process take, and what restrictions will I have post-surgery?
  5. Will the fibroids come back after the surgery, and if so, how soon?
  6. Are there alternative treatments for managing fibroids during pregnancy?
  7. How will the surgery be performed (abdominally, laparoscopically, vaginally) and what are the differences in outcomes?
  8. How many fibroids will be removed during the surgery?
  9. Will the surgery affect my ability to conceive in the future?
  10. What is the success rate of myomectomy during pregnancy, and what are the chances of complications occurring?

Reference

Authors: Spyropoulou K, Kosmas I, Tsakiridis I, Mamopoulos A, Kalogiannidis I, Athanasiadis A, Daponte A, Dagklis T. Journal: Eur J Obstet Gynecol Reprod Biol. 2020 Nov;254:15-24. doi: 10.1016/j.ejogrb.2020.08.018. Epub 2020 Aug 25. PMID: 32919229