Affiliation:
1. Women’s Reproductive Health Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
2. Department of Obstetrics and Gynecology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
3. Research Center
for Evidence Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of
Medical Sciences, Tabriz, Iran
Abstract
Background:
Performing myomectomy concurrently with a caesarean section has been
controversial for many decades.
Objective:
The present study mainly aims to evaluate the consequences of concurrent myomectomy
and caesarean section versus caesarean section alone.
Methods:
In this systematic review, we have followed the Preferred Reporting Items for Systematic
Reviews and Meta-analyses (PRISMA) guidelines. Electronic resources, such as MEDLINE,
Cochrane, EMBASE, Scopus, and PubMed, were searched. A total of 3057 articles were reviewed. Of
these, 33 met the inclusion criteria and were included in the final analysis. The reviewed outcomes
were hemoglobin (Hb) before and after the operation, blood transfusion rate, hemorrhage, operation
time, duration of hospitalization, and complications, such as fever.
Results:
A meta-analysis of 33 articles with 5586 participants in the caesarean myomectomy (CM)
group and 2935 participants in the caesarean section (CS) group showed a statistically significant Hb
decrease in the CM group [MD = 0.26, CI=95%(-0.33 to -0.19)]. The transfusion rate was higher in
the CM group [OR=0.39(0.42-0.67)], and intraoperative hemorrhage was higher in the CM group
[OR=0.56 (0.45 - 0.75) CI=95%]. The mean operation time [MD=1.17(1.10 -1.24) CI=95] and hospitalization
time [MD=0.41 (0.34-0.48) CI=95%] were significantly higher in the CM group. There was
no significant difference in the incidence of fever between the two groups [MD =1.06, CI=95%,
p=0.923(0.78-1.43)].
Conclusion:
Concurrent CM is associated with a reduction in mean Hb and an increase in operation
time and hospitalization time; however, it prevents additional surgery and costs; it is worthwhile to
perform myomectomy at the time of caesarean section, especially by experienced surgeons with necessary
preparations.
Publisher
Bentham Science Publishers Ltd.
Subject
Obstetrics and Gynecology