Unavoidable caesarean myomectomy: a case report

Abstract

The standard practice is to avoid myomectomy during caesarean section. We present a case of myomectomy performed during caesarean section in a 32 year old primiparous woman. Uterine fibroid was diagnosed at 25 weeks gestation at the antenatal booking clinic. Patient was however symptom free throughout pregnancy. Elective caesarean section was undertaken at 38 weeks gestation on account of breech presentation and major placenta praevia. After delivery of the baby and placenta, the fibroid mass made uterine wound closure impossible, necessitating myomectomy. High dose oxytocin infusion was used to control intra-operative and post-operative haemorrhage. Outcome for mother and baby were satisfactory. Caesarean myomectomy can be safely undertaken in experienced hands whilst applying measures to reduce intra-operative and post-operative blood loss.

Keywords: uterine fibroid, caesarean myomectomy, haemorrhage

Tropical Journal of Obstetrics and Gynaecology Vol. 22(1) 2005: 81-82