- Increased maternal risks with planned cesarean delivery (CD) after previous myomectomy.
Why this matters
- Uterine fibroids are benign tumors affecting women of reproductive age and are associated with pain, abnormal bleeding, increased risk of miscarriage, preterm labor, and postpartum hemorrhage.
- Surgical removal may result in recommendations for planned CD because of concerns about uterine rupture during labor.
- The rate of intraoperative blood transfusion was higher in the myomectomy group (aOR, 2.8; 95% CI, 1.15-6.79).
- The rate of postpartum blood transfusion was higher in the myomectomy group (aOR, 2.03; 95% CI, 1.06-3.92).
- Women with myomectomy were more likely to experience bowel injury, have a cesarean hysterectomy, and require a classical uterine incision.
- No significant differences in rates of uterine atony, uterine rupture, wound complications, or endometritis.
- No differences in neonatal outcomes.
- Retrospective cohort study using data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network Cesarean Registry database.
- Women undergoing planned CD with (n=367) and without (n=33,635) a history of myomectomy compared.
- Primary outcome was the incidence of blood transfusion.
- Funding: None.
- No operative details of myomectomy including size of fibroids or type of closure.