Fertility and obstetric outcome after caesarean myomectomy

This is a prospective non-randomised study to determine the fertility performance and pregnancy outcome in pregnant females who had caesarean myomectomy at last delivery. A total of 29 females were studied and they had a mean age of 37.3 years. Of these, 22 (75.9%) of the females were para 1 and 25 (86.2%) had had one previous caesarean section. Only six (20.7%) of them had fertility treatment before the attainment of the index pregnancy. The common antenatal complications recorded were abnormal lie/malpresentation (10.3%), placenta praevia (10.3%) and threatened abortion (10.3%); 17 patients were eligible for trial of scar; 13 (44.8%) had successful vaginal birth after caesarean myomectomy, while 16 (55.2%) had repeat caesarean section including a caesarean hysterectomy. Postoperative morbidity was recorded in four (25%) of the 16 patients that had abdominal delivery. There was no maternal or perinatal mortality recorded. The future fertility and or subsequent pregnancy outcome in patients is unaffected by caesarean myomectomy.