Simultaneous Myomectomy and Cesarean Section: A Dual Surgical Approach Pregnancy with enormous fibroid

Abstract

Introduction: Myomectomy during cesarean section (CS) is a complex but increasingly common surgical approach used in cases of large uterine fibroids in pregnant patients. This report aims to evaluate the efficacy and safety of myomectomy in conjunction with CS for large uterine myoma.

Case description: A retrospective study was conducted on two pregnant patients with large uterine myomas who underwent myomectomy during CS at a Hospital of Universitas Airlangga. Clinical data, myoma characteristics, and maternal and neonatal outcomes were evaluated. Myoma sizes were 15x15cm and 15x20cm, and both were intramural. No significant intraoperative complications occurred. Bleeding during surgery was well controlled, and all patients recovered without adverse events. The duration of surgery was 60 and 70 minutes. Patients were discharged home within 3 days after surgery, and all neonates were born healthy with no congenital abnormalities.

Conclusion: Simultaneous myomectomy with CS is a successful and safe method of managing big uterine myomas in pregnant women. This surgery has two advantages: it treats maternal fibroid problems while also ensuring maternal and newborn safety during CS. The installation of a Foley catheter for uterine artery clamping aids in preventing excessive bleeding during surgery. This method can be used to handle pregnant individuals with big uterine myomas who require CS.