Cesarean Myomectomy: Necessity or Opportunity?

Area of Science:

• Obstetrics and Gynecology
• Reproductive Medicine
• Surgical Innovation

Background:

• Uterine fibroids during pregnancy are more prevalent due to factors like increased maternal age and assisted reproductive technologies.
• Cesarean section (CS) is the primary delivery method for pregnant individuals with fibroids.
• Cesarean myomectomy (CM), the concurrent removal of fibroids during CS, remains a topic of debate.

Purpose of the Study:

• To review current literature on Cesarean myomectomy (CM).
• To evaluate the indications, surgical techniques, safety profile, and applicability of CM in contemporary obstetrics.
• To assess the value of CM, especially in resource-limited environments.

Main Methods:

• Systematic review of recently published data on Cesarean myomectomy.
• Analysis of studies focusing on CM indications, surgical procedures, and patient outcomes.
• Examination of literature regarding complications, benefits, and cost-effectiveness.

Main Results:

• While historically controversial due to hemorrhage risks, recent evidence supports CM in selected cases.
• CM can be safely performed during Cesarean section, with appropriate patient selection.
• The procedure offers significant advantages in low-resource settings by preventing a second surgery, anesthesia, and associated costs.

Conclusions:

• Cesarean myomectomy is a viable and beneficial procedure when performed selectively during Cesarean sections.
• CM can reduce the need for future surgeries and healthcare costs, particularly in underserved regions.
• Further research and standardized guidelines can enhance the adoption and safety of CM in modern obstetric practice.