[Management of uterine myomas during pregnancy].
ACTA ACUST UNITED AC 2016;
44:350-4. [PMID:
27216952 DOI:
10.1016/j.gyobfe.2016.04.007]
[Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 04/14/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE
To assess the impact of myomas on pregnancy and discuss the role of myomectomy during cesarean section.
METHODS
Databases PubMed, Medline and Cochrane were searched until 30 June 2015.
RESULTS
The most commonly reported obstetric complications relative to fibroids are: increased rate of spontaneous miscarriage in women with submucosal or intramural fibroids, pain, placentation disorders and malpresentation. A higher cesarean section rate is found among pregnant women with fibroids. The most common postpartum complication is postpartum haemorrhage. For years, risk of haemorrhage led caregivers not to practice myomectomy during cesarean section. Current data are rather reassuring. No study shows significant hemorrhage differences between myomectomy during cesarean section and cesarean section alone or myomectomy alone. The long-term morbidity of myomectomy during cesarean section is not enough studied but does not appear higher than expected for fertility and complications during pregnancy. Therefore, myomectomy during cesarean section is not currently recommended by learned societies.
CONCLUSION
Women with fibroids is a common obstetric situation. Complications are rare. Myomectomy during cesarean section seems to be not associated with higher short-term maternal morbidity. But studies with a longer-term follow-up of patients are necessary.
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