Caesarean Myomectomy in a Tertiary Care Hospital in Meghalaya: A Case Series

Objective: To study the safety and feasibility of performing myomectomies during caesarean section. Methods: It is a retrospective observational study.13 cases of Caesarean myomectomies were performed from June 2019 to June 2021, at our institution ? a tertiary health care centre in Meghalaya. Myomectomy was done after delivery of baby in all cases. This was followed by suturing and adequate haemostasis. The maternal demographics and characteristics of fibroids, operative time, intraoperative and postoperative complications, need for blood transfusion and duration of hospital stay were analysed. Results: The average age of women was 36.15 years and mean gestational age at delivery was 38 weeks. Regarding intra - operative blood loss, more than average blood loss was seen in 4 patients. Blood transfusion was required for 2patient while 2 patients received injectable iron preparation post operatively. Despite the majority being large myomas (9 of the 13 patients had myomas greater than5 cm in size) and 5 being intramural, no hysterectomy was required. Myomectomy added a mean increase of 37.07 minutes to the operating time. There was no difference in duration of hospital stay and postoperative complications as well. Neonatal outcome was good in all patients. Conclusion: In our study we found that myomectomy during Caesarean section is a safe and effective procedure, when done at tertiary centres, under expert hands.