Inevitable cesarean myomectomy and delivery of baby through the same incision

Abstract

Leiomyoma is the commonly encountered benign tumor in women of reproductive age group. Cesarean myomectomy is associated with increased morbidity and mortality mainly due to the risk of associated hemorrhage. Although there are some case series that have demonstrated the safety of myomectomy during cesarean section, a 32-year-old female G2P1 + 0 was referred to the emergency department of obstetrics and gynecology with a complaint of pain in the lower abdomen with amenorrhea of 8 months. Her transabdominal ultrasound report showed a huge fibroid in the lower uterine segment of 16 cm × 12 cm × 14 cm predominantly in the anterior wall of the uterus. Here, cesarean myomectomy was done under spinal anesthesia before the delivery of alive and healthy male baby, weighing 3.0 kg successfully without any complication. Though the cesarean myomectomy is difficult and is associated with increased morbidity because of risk of associated hemorrhage; thus, we do not always recommend but it could be performed in unavoidable conditions