Safety analysis of cesarean myomectomy in twin pregnancies with intramural myomas
10.3760/cma.j.cn112141-20220721-00472
- VernacularTitle:双胎妊娠合并肌壁间子宫肌瘤孕妇剖宫产术时行肌瘤剔除术的安全性分析
- Author:
Hongmei WANG
1
;
Rugang SHEN
;
Huijuan YANG
;
Yucui TIAN
;
Chunliu ZHANG
;
Yinmei DAI
Author Information
1. 首都医科大学附属北京妇产医院 北京妇幼保健院围产保健科，北京 100026
- Keywords:
Pregnancy, twin;
Cesarean section;
Leiomyoma;
Uterine neoplasms;
Pregnancy complications, neoplastic;
Uterine myomectomy
- From:
Chinese Journal of Obstetrics and Gynecology
2022;57(11):843-849
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To estimate the safety of myomectomy in twin pregnant women with intramural myomas during cesarean section.Methods:The clinical data of 145 cases of twin pregnancies with intramural myomas who were delivered by cesarean section in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from June 2013 to December 2021 were collected. Maternal demographics, fibroids′ characteristics, maternal and fetal outcomes were compared between groups of cesarean section with myomectomy (myomectomy group, 49 cases) and cesarean section only (non-myomectomy group, 96 cases).Results:Compared with non-myomectomy group, myomectomy group had significantly prolonged operative time [50.0 minutes (37.5-57.5 minutes) vs 40.0 minutes (35.0-50.0 minutes), respectively; P=0.007] and significantly longer postoperative hospital stay [4.0 days (3.0-4.0 days) vs 3.0 days (3.0-4.0 days), respectively; P=0.047). Other maternal and fetal outcomes such as estimated blood loss, hemoglobin difference, postpartum hemorrhage, blood transfusion, B-Lynch structure, uterine artery ligation, postoperative fever and neonatal Apgar score showed no significant differences (all P>0.05). For intramural myomas <5 cm, there were no significant differences in maternal and fetal outcomes between myomectomy group and non-myomectomy group (all P>0.05). For intramural myomas ≥5 cm, operative time [55.0 minutes (40.0-60.0 minutes) vs 42.5 minutes (40.0-50.0 minutes), respectively; P=0.019] was significantly prolonged, postoperative hospital stay [4.0 days (4.0-5.0 days) vs 4.0 days (3.0-4.0 days), respectively; P=0.048] was significantly longer in myomectomy group than non-myomectomy group, but there were no significant differences in other maternal and fetal outcomes (all P>0.05). Conclusion:For twin pregnancies with intramural myomas, it is safe and feasible to remove intramural myomas during cesarean section by experienced obstetricians.
