The Update on the Role of Cesarean Myomectomy in an Old Primigravida with Huge and Painful Myoma: a Challenging Case for Fertility-Preserving Surgery

Abstract

Abstract There is no established protocol for reducing maternal and perinatal morbidities in myoma during pregnancy. The opinions regarding performing myomectomy during cesarean section have been inconsistent and hot topic of discussion. The recent trends regarding the pro and cons outcomes are caused by potential risk of massive hemorrhage, repeat operation and anesthesia, less time away from work, prolong duration of operation and hospital stay, need of transfusion, increased overall cost, and morbidity. We presented a case of 42-year-old primigravida at 37-38 weeks of singleton live pregnancy with intramural myoma, and then performed successfully cesarean section and myomectomy without complication. The results of the operation showed a safe outcome when performed by an experienced obstetrician and selective case, and helped maintain fertility sparing in the future. Keywords: Uterine myoma, Cesarean myomectomy, Old primigravida