Long-term obstetric, perinatal, and surgical complications in singleton pregnancies following previous cesarean myomectomy: a retrospective multicentric study.
| Autor: | Güler O; Department of Obstetrics and Gynecology, Private Asya Hospital, Istanbul, Turkey., Hatırnaz Ş; Department of Obstetrics and Gynecology, Mediliv Medical Center, Samsun, Turkey., Sparic R; Clinic for Obstetrics and Gynecology, University Clinical Center of Serbia, Belgrade, Serbia.; Faculty of Medicine, University of Belgrade, Belgrade, Serbia., Basbug A; Department of Obstetrics and Gynecology, School of Medicine, Duzce University, Duzce, Turkey., Erol O; Department of Obstetrics and Gynecology, Memorial Antalya Hospital, Antalya, Turkey., Kalkan Ü; Department of Obstetrics and Gynecology, Koç University Hospital, Istanbul, Turkey., Ulubaşoğlu H; Department of Obstetrics and Gynecology, Ankara Bilkent City Hospital, Ankara, Turkey., Trojano G; Department of Obstetrics and Gynecology, Madonna Delle Grazie Hospital, Matera, Italy., Ürkmez SS; Department of Medical Biochemistry, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkiye., Tinelli A; Department of Obstetrics and Gynecology, and CERICSAL (CEntro di RIcerca Clinico SALentino), 'Veris delli Ponti Hospital', Scorrano, Italy. |
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| Jazyk: | angličtina |
| Zdroj: | Frontiers in surgery [Front Surg] 2024 Aug 01; Vol. 11, pp. 1430439. Date of Electronic Publication: 2024 Aug 01 (Print Publication: 2024). |
| DOI: | 10.3389/fsurg.2024.1430439 |
| Abstrakt: | Objectives: The safety of cesarean myomectomy has been proven by previous studies. Our study aimed to reveal the long-term perinatal, obstetric, and surgical outcomes of cesarean myomectomy (CM) by comparing different CM techniques. Material and Methods: This retrospective multicentric case-control study involved 7 hospitals and included 226 singleton pregnancies that underwent repeated cesarean section (CS) between 2015 and 2020. Among these pregnancies, 113 of 226 cases had CM (Group A), and 113 had only CS (Group B). Of the 113 cases in which CM was performed, 58 underwent endometrial myomectomy (EM) (Subgroup A1) and 55 underwent serosal myomectomy (SM) (Subgroup A2). The groups were compared in terms of obstetric, perinatal, and surgical outcomes, and fibroid recurrence, myomectomy scar healing rate, and adhesion formation were noted. Results: There was no significant difference between the groups in terms of maternal age, body mass index, gravidity, parity, and fibroid diameter in previous CS ( p > 0.05). In the perinatal and obstetric evaluation of the groups, there was no significant difference between the groups in terms of neonatal weight, Apgar score, fetal growth restriction, preterm premature rupture of membranes, preterm delivery, hypertension in pregnancy, and diabetes mellitus ( p > 0.05). The fibroid recurrence rate was 28.3%, and the myomectomy scar good healing rate was 99.1%. There was no difference between the groups in terms of CS duration, preoperative and postoperative hemoglobin levels, perioperative blood transfusion rates, febrile morbidity, and prolonged hospitalization ( p > 0.05). In terms of adhesion formation, although the adhesion rate of the SM group was higher than that of the EM group, no statistically significant difference was detected between the groups. Conclusion: This study showed that in pregnancies following CM, obstetrical, perinatal, and surgical outcomes were unaffected. Obstetricians can safely use CM, either the trans-endometrial or serosal technique, as it is a safe and effective method with long-term results. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision. (© 2024 Güler, Hatırnaz, Sparic, Basbug, Erol, Kalkan, Ulubaşoğlu, Trojano, Ürkmez and Tinelli.) |
| Databáze: | MEDLINE |
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