Published: 2022-07-27

Caesarean myomectomy in a patient with multiple maternal and fetal comorbidities: a rare interesting case report

Zeba H. Pathan, Niranjan N. Chavan, Shreya Kampoowale, Deepali S. Kapote, Ashwini S. Sakhalkar


Caesarean myomectomy has been traditionally discouraged due to the fear of complications like intractable haemorrhage, peripartum hysterectomy, and increased postoperative morbidity. Recently, a number of authors in their studies have shown that myomectomy during caesarean section does not increase the risk of haemorrhage or postoperative morbidity, if adequate haemostatic methods are used and done by skilled surgical hands. Caesarean myomectomy was performed in a case of elderly primigravida with 36-week gestation with chronic hypertension with polyhydramnios with anterior wall pedunculated fibroid of 8.6×7.2×8 cm and multiple small fibroids in the anterior wall, fundus and subserosal plane. Caesarean myomectomy is a safe and effective procedure in a tertiary care centre at hands of an experienced surgeon.


Fibroid, Pregnancy, Myomectomy, Caesarean section, Mumbai, India

Full Text:



Febo G, Tessarolo M, Leo L, Arduino S, Wierdis T, Lanza L. Surgical management of leiomyomata in pregnancy. Clin Exp Obstetr Gynecol. 1997;24(2):76-8.

Roman AS, Tabsh KMA. Myomectomy at time of cesarean delivery: a retrospective cohort study. BMC Pregnancy Childbirth. 2004;4:14.

Bhatla N, Dash BB, Kriplani A, Agarwal N. Myomectomy during pregnancy: a feasible option. J Obstetr Gynaecol Res. 2009;35(1):173-5.

Gbadebo AA, Charles AA, Austin O. Myomectomy at caesarean section: descriptive study of clinical outcome in a tropical setting. J Ayub Med College Abbottabad. 2009;21(4):7-9.

Abasiattai AM, Bassey EA, Essien EU, Utuk NM. Inevitable myomectomy during caesarean section: a case report. Nig J Clin Pract. 2009;12(1):99-100.

Gloria A, Bachmann MD, Linda A, Bahouth BA, Amalraj P, Mhamunkar V et al. Correlation of anemia and pain to fibroid location and uterineweight. J Reprod Med. 2011;56:463-6.

Garg R. Two uncommon presentations of cervical fibroids. People’s J Sci Res. 2012;5(2).

Khyade RL. A study of menstrual disturbance in cases of fibroid uterus. Int J Reprod Contracept Obstet Gynecol. 2017;6(6):2494-7.

Shaheen S, Naheed T, Sadaf F, Rahim R; Menorrhagia due to fibroids and its management. JSOGP. 2013;3(4):231-5.

Munusamy MM, Sheelaa WG, Lakshmi VP. Clinical presentation and prevalence of uterine fibroids: a 3-year study in 3-decade rural South Indian women. Int J Reprod Contracept Obstet Gynecol. 2017;6(12):5596-01.

Atombosoba A, Ekine, Lawani LO, Iyoke CA, Jeremiah I, Ibrahim IA. Review of clinical presentation of uterine fibroids and the effect of therapeutic intervention on fertility. Am J Clin Med Res. 2015;3(1):9-13.

Brown D, Fletcher HM, Myrie MO, Reid M. Caesarean myomectomy-a safe procedure. A retrospective case-controlled study. J Obstet Gynaecol. 1999;19(2):139-41.

Kwawukume EY. Caesarean myomectomy. Afr J Reproduct Health. 2002;6(3):38-43.

Omar SZ, Sivanesaratnam V, Damodaran P. Large lower segment myoma-myomectomy at lower segment Caesarean section-a report of two cases. Singapore Med J. 1999;40(2):109-10.

Cobellis G, Messalli EM, Stradella L, Pecori E, Cobellis L. Restitutio ad integrum of myometrium after myomectomy: different results in pregnant and non-pregnant patients. Minerva Ginecologica. 2002;54(5):393-5.

Kongnyuy EJ, Wiysonge CS. Interventions to reduce haemorrhage during myomectomy for fibroids. Cochrane Database Systematic Rev. 2009;3:CD005355.