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Perioperative Complications of Cesarean Delivery Myomectomy.

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eMediNexus    11 November 2017

A new study published in Obstetrics and Gynecology assessed the association of myomectomy during cesarean delivery with intraoperative and perioperative maternal morbidity. In this meta analysis a search was conducted MEDLINE 1966 2017 Scopus 2004 2017 ClinicalTrials.gov 2008 2017 EMBASE 1980 2017 and Cochrane Central Register of Controlled Trials CENTRAL 1999 2017 databases to include all observational studies that reported outcomes on patients undergoing myomectomy at the time of cesarean delivery. Overall 19 studies were selected which comprised 3 900 women. Among these 2 301 women had myomectomy during cesarean delivery and 1 599 had cesarean delivery only. The review revealed that women undergoing concomitant myomectomy had a mild decline in hemoglobin when compared to those who had cesarean delivery only. Myomectomy at the time of cesarean delivery was found to be associated with longer surgical time compared to cesarean delivery alone. Whereas blood transfusion and postoperative fever rates did not differ between the two groups myomectomy compared with no myomectomy . Furthermore a statistically but not clinically significant increase in postoperative hospitalization was obvious in the myomectomy group. The findings of this study demonstrated an association with increased operative time and hemoglobin drop in patients who underwent cesarean myomectomy compared to cesarean delivery alone. Whereas no increased rate of major hemorrhage or need for transfusion was identified. It was suggested that cesarean myomectomy may be considered in cases of isolated myomas.

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