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Uterine dehiscence following laparoscopic myomectomy
1Bristol Regional Medical Center, James H. Quillen College of Medicine, East Tennessee State University.
Background:
Laparoscopic myomectomy is a new procedure that is growing in popularity. The natural history of pregnancy following laparoscopic myomectomy is unknown.
Case:
A 24-year-old white woman, gravida 0, with infertility and endometriosis, conceived after a laparoscopic procedure that included myomectomy. At 34 weeks' gestation, the patient experienced uterine dehiscence at the site of myomectomy. An emergency cesarean delivery was performed and the uterus was oversewn. Both mother and infant had satisfactory hospital courses.
Conclusion:
Meticulous closure of the myometrial bed following myomectomy is difficult via the laparoscope, and this could interfere with the integrity of the scar. If further studies confirm this experience, then laparoscopic myomectomy may need to be limited to patients who do not desire further childbearing.
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