Pregnancy outcome after laparoscopic myomectomy

Area of Science:

• Reproductive Medicine
• Minimally Invasive Surgery
• Gynecologic Oncology

Background:

• Uterine fibroids (myomas) are common and can impact fertility and pregnancy.
• Surgical options for myoma removal include abdominal, vaginal, and laparoscopic approaches.
• Laparoscopic myomectomy offers potential benefits like reduced recovery time but its impact on reproductive outcomes requires analysis.

Purpose of the Study:

• To evaluate the reproductive and obstetrical outcomes following laparoscopic myomectomy.
• To assess delivery modes and the incidence of major complications such as uterine bleeding and rupture.
• To analyze pregnancy and abortion rates in women desiring conception after the procedure.

Main Methods:

• An observational study was conducted on patients undergoing laparoscopic myomectomy for single or multiple myomas (5-15 cm) with a desire for pregnancy.
• Data collected included pregnancy success, time to pregnancy, use of assisted reproductive medicine, gestational age, delivery mode, and complications.
• Pregnancy and abortion rates were calculated from the collected data.

Main Results:

• 185 women desiring pregnancy were included; 115 (62.2%) achieved 151 pregnancies.
• Of these, 111 were successful pregnancies with 7 preterm deliveries (6.3%).
• Cesarean section was performed in 63.4% of deliveries, and vaginal delivery in 36.6%.

Conclusions:

• Laparoscopic myomectomy is an effective procedure for women desiring pregnancy, with reproductive outcomes comparable to literature.
• Adequate laparoscopic suturing of the myometrial incision does not contraindicate vaginal delivery.
• The procedure is feasible regardless of myoma size, number, location, or patient age.