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Updated: Dec 18, 2025
Introduction of Intracapsular Rotary-cut Procedures IRCP: A Modified Hysteromyomectomy Procedures Facilitating Fertility Preservation
Published on: January 17, 2019
Myomectomy associated blood transfusion risk and morbidity after surgery
Tana Kim1, Mackenzie P Purdy1, Lauren Kendall-Rauchfuss2
1Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota; Division of Reproductive Endocrinology and Infertility, Mayo Clinic, Rochester, Minnesota.
Objective:
To evaluate blood transfusion risks and the associated 30-day postoperative morbidity after myomectomy.
Design:
Retrospective cohort study.
Setting:
Not applicable.
Patient(S):
Women who underwent myomectomies for symptomatic uterine fibroids (N = 3,407).
Intervention(S):
Blood transfusion during or within 72 hours after myomectomy.
Main Outcome Measure(S):
The primary outcomes were rate of blood transfusion with myomectomy and risk factors associated with receiving a transfusion. The secondary outcome was 30-day morbidity after myomectomy.
Result(S):
The overall rate of blood transfusion was 10% (hysteroscopy, 6.7%; laparoscopy, 2.7%; open/abdominal procedures, 16.4%). Independent risk factors for transfusion included as follows: black race (adjusted odds ratio [aOR] 2.27, 95% confidence interval [CI] 1.62-3.17) and other race (aOR 1.77, 95% CI 1.20-2.63) compared with white race; preoperative hematocrit <30% compared to ≥30% (aOR 6.41, 95% CI 4.45-9.23); preoperative blood transfusion (aOR 2.81, 95% CI 1.46-5.40); high fibroid burden (aOR 1.91, 95% CI 1.45-2.51); prolonged surgical time (fourth quartile vs. first quartile aOR 11.55, 95% CI 7.05-18.93); and open/abdominal approach (open/abdominal vs. laparoscopic aOR 9.06, 95% CI 6.10-13.47). Even after adjusting for confounders, women who required blood transfusions had an approximately threefold increased risk for experiencing a major postoperative complication (aOR 2.69, 95% CI 1.58-4.57).
Conclusion(S):
Analysis of a large multicenter database suggests that the overall risk of blood transfusion with myomectomy is 10% and is associated with an increased 30-day postoperative morbidity. Preoperative screening of women at high risk for transfusion is prudent as perioperative transfusion itself leads to increased major postoperative complications.
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