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Modeling Ascending Vaginal Infection, Preterm Birth, and Neonatal Morbidity in Mice
Published on: October 10, 2025
522
Vaginal birth after prior myomectomy
Z M Gambacorti-Passerini1, C Penati2, A Carli3
1University of Milano Bicocca, Milan, Italy.
European Journal of Obstetrics, Gynecology, and Reproductive Biology
|November 6, 2018
Summary
Vaginal birth after myomectomy is safe and successful for most women. Trial of labor after myomectomy (TOLAM) resulted in high vaginal delivery rates with no uterine ruptures, suggesting it
Area of Science:
- Reproductive Medicine
- Gynecologic Surgery
- Obstetrics
Background:
- Myomectomy, surgical removal of uterine fibroids, is common.
- Pregnancy following myomectomy requires careful consideration of delivery mode.
- Prior surgical characteristics may influence obstetrician decisions.
Purpose of the Study:
- To assess obstetrical and perinatal outcomes of vaginal birth after myomectomy.
- To explore the impact of surgical details on delivery mode selection.
Main Methods:
- Retrospective cohort study of women who underwent myomectomy (laparoscopic or laparotomic).
- Analysis of subsequent pregnancies, deliveries (≥24 weeks), and operative characteristics.
- Phone interviews for data collection on outcomes and surgical history.
Main Results:
- 152 pregnancies occurred post-myomectomy; 110 resulted in delivery at ≥24 weeks.
- Trial of labor after myomectomy (TOLAM) was attempted in 66.4% of cases, with 90.4% achieving vaginal delivery.
- No uterine ruptures or perinatal deaths occurred; NICU admission was 14.5%.
Conclusions:
- Trial of labor after myomectomy (TOLAM) is a feasible and safe option for achieving vaginal birth.
- High success rates and absence of severe complications support TOLAM.
- Entry into the uterine cavity during myomectomy appears to influence obstetricians' delivery mode choices.
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