Myomectomy during pregnancy: A systematic review

Area of Science:

• Reproductive Medicine
• Gynecologic Surgery
• Obstetrics

Background:

• Uterine fibroids affect 2-10% of pregnant women, often asymptomatic but can cause complications.
• Antenatal myomectomy is typically avoided but considered for symptomatic cases refractory to conservative management.

Purpose of the Study:

• To systematically review and analyze published literature on antenatal myomectomy.
• To report outcomes and associated risks of myomectomy during pregnancy.

Main Methods:

• Systematic literature search of PubMed/MEDLINE, Scopus, and Cochrane Library.
• Inclusion of case reports and case series for numerical analysis.
• Analysis of patient demographics, surgical details, and pregnancy outcomes.

Main Results:

• 54 articles identified, reporting on 97 patients; median gestational age at diagnosis was 13 weeks.
• Abdominal pain unresponsive to medical treatment was the primary indication for surgery.
• Laparotomy was the main approach (78.4%); favorable pregnancy outcomes were reported in most cases with few complications.

Conclusions:

• Antenatal myomectomy appears safe for symptomatic uterine fibroids unresponsive to conservative measures.
• The procedure may be considered following thorough counseling on potential risks.
• Limited data suggests favorable pregnancy outcomes, warranting further investigation.