Cesarean Myomectomy: A Retrospective Observational Study at a Tertiary Care Center in Bihar, India.

Introduction Fibroids during pregnancy are frequently encountered in our routine obstetric practice. Whether cesarean myomectomy is a safe and practical treatment for women with uterine myomas or if it is completely contraindicated is a topic of much discussion. Due to the apprehension of increased blood loss, there remains a dilemma in obstetricians' decisions on whether to do a cesarean myomectomy or not. Our article may help obstetricians to make an informed decision. Method We did a single-center, uncontrolled, retrospective observational study on 25 cases who were enrolled over two years. Data were analyzed in terms of intraoperative blood loss, need for blood transfusion, operative time, hospital stay, and postoperative morbidity. Results The mean age of patients in our study was 29.1 years, and the mean gestational age at delivery in our study was 37.5 weeks. In our study, the size of uterine fibroids ranged between 4 and 16 cm. The mean operative time was 68.12 minutes. The mean drop in hemoglobin between pre- and post-op was 1.1 g/dL. There was a history of blood transfusion in seven out of 25 cases. There was no significant postoperative morbidity in all the cases, except for one, and the mean hospital stay was five days. Neonatal outcome was good in 22 cases with three neonatal intensive care unit (NICU) admissions. Conclusion  This study concluded that myomectomy is feasible with acceptable short-term outcomes with good technique in expert hands in a tertiary care center. This has the advantages of avoiding a second surgery and cost when cases are selected appropriately.