Gynecology World Conference 2026

Abstract

Introduction: Leiomyoma, a common benign tumor of the uterus, frequently occurs in women of reproductive age. While often asymptomatic, symptomatic cases may present with menstrual disturbances and complications during pregnancy and labor, depending on the size and location of the fibroid. Cesarean myomectomy has traditionally been avoided due to the risk of hemorrhage; however, it is increasingly being performed with advances in surgical techniques and availability of blood transfusion services. This study aims to evaluate the safety and maternal outcomes of cesarean myomectomy in a tertiary care setting.

Methodology: This is a retrospective descriptive study conducted in the Department of Obstetrics and Gynecology, Tribhuvan University Teaching Hospital. Patients diagnosed with uterine fibroid during elective/emergency cesarean section and who underwent myomectomy in the same setting were included. Detailed demographics and outcome of C/M were analyzed in terms of number, types, site and size of fibroid removed, intraoperative blood loss, need for blood transfusion, perioperative complications and duration of hospital stay.

Results: A total of 43 cases of c/m were analyzed in three years. Most women were aged 30–40 years (65.1%) and primigravida (74.4%). The majority were term (95.3%) pregnancy. Emergency cesarean section was more common (63%) than elective (37%). Fibroids measuring 2–15 cm maximum of three, predominantly from upper uterine segment were removed. Most were subserosal (73.3%), followed by intramural types. Intraoperative blood loss ranged from 100–700 ml. Only one patient required bilateral uterine arteries ligation & compression sutures for severe hemorrhage, while two required blood transfusions. The mean hemoglobin drop post-surgery was 0.23gm/dl. Postoperative complications were pyrexia, anemia, and chest infection each occurring in 6.7% patients. The mean hospital stay was 3.5 days.                               

Conclusions: With proper case selection and in experienced hand cesarean myomectomy can be performed with minimal additional morbidity.