Our Summary

This research paper is about a study that looked into how safe it is to remove fibroids (non-cancerous growths in the uterus) during a cesarean section (C-section) delivery. The researchers looked at data from 3,900 women - about 2,300 of these women had fibroids removed during their C-section, while the rest only had a C-section.

The study found that women who had fibroids removed during their C-section had a slight decrease in their hemoglobin levels (a protein in the blood that carries oxygen) compared to those who only had a C-section. The surgery also took a bit longer for those who had fibroids removed. However, there was no significant difference in the rate of blood transfusions or post-surgery fever between the two groups.

In conclusion, removing fibroids during a C-section may take a little more time and cause a slight drop in hemoglobin, but it doesn’t seem to increase the risk of major bleeding or the need for a blood transfusion. However, more research is needed to confirm these findings.

FAQs

  1. Is it safe to remove fibroids during a C-section?
  2. What are the potential risks of removing fibroids during a C-section?
  3. Does removing fibroids during a C-section increase the risk of major bleeding or the need for a blood transfusion?

Doctor’s Tip

A helpful tip a doctor might tell a patient about myomectomy is to discuss the risks and benefits of the procedure with their healthcare provider. It is important to have a thorough understanding of the potential complications, such as a drop in hemoglobin levels, before undergoing surgery. Additionally, patients should be aware that the surgery may take longer if fibroids are being removed during a C-section. It is also important to follow post-operative care instructions to ensure a smooth recovery.

Suitable For

Patients who are typically recommended myomectomy are those who are experiencing symptoms such as heavy menstrual bleeding, pelvic pain, pressure or fullness in the lower abdomen, frequent urination, constipation, or backache due to fibroids. Additionally, myomectomy may be recommended for patients who are trying to conceive and have infertility issues due to the presence of fibroids. In some cases, myomectomy may also be recommended for patients with rapidly growing fibroids, fibroids that are causing complications such as urinary tract problems or severe pain, or for patients who prefer to preserve their uterus for future childbearing. Ultimately, the decision to undergo myomectomy should be made in consultation with a healthcare provider after considering the individual patient’s symptoms, medical history, and reproductive goals.

Timeline

Before a myomectomy, a patient may experience symptoms such as heavy menstrual bleeding, pelvic pain, frequent urination, and pressure or fullness in the lower abdomen. They may also undergo imaging tests such as ultrasounds or MRIs to confirm the presence of fibroids.

After a myomectomy, the patient may experience pain and discomfort in the pelvic area for a few days to weeks. They may also have spotting or light bleeding for a few weeks after the surgery. It is important for the patient to follow their doctor’s post-operative instructions, which may include restrictions on physical activity and recommendations for pain management. Over time, the patient should experience relief from their fibroid symptoms and improved quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about myomectomy during a C-section include:

  1. What are the potential risks and benefits of having my fibroids removed during my C-section?
  2. How will removing fibroids affect my recovery time after the C-section?
  3. Will removing fibroids during the C-section increase my risk of complications during or after the surgery?
  4. How will removing fibroids during the C-section affect my future fertility or ability to have more children?
  5. Are there any alternative treatment options for my fibroids that do not involve surgery during the C-section?
  6. What is the experience and expertise of the surgical team in performing myomectomies during C-sections?
  7. How often do you perform myomectomies during C-sections, and what is your success rate with this procedure?
  8. What is the likelihood of needing a blood transfusion during or after the surgery if I choose to have my fibroids removed during the C-section?
  9. How will my hemoglobin levels be monitored during and after the surgery to ensure my safety?
  10. Are there any specific precautions or guidelines I should follow before and after the surgery if I choose to have my fibroids removed during the C-section?

Reference

Authors: Pergialiotis V, Sinanidis I, Louloudis IE, Vichos T, Perrea DN, Doumouchtsis SK. Journal: Obstet Gynecol. 2017 Dec;130(6):1295-1303. doi: 10.1097/AOG.0000000000002342. PMID: 29112662