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The risk of uterine rupture after myomectomy: a systematic review of the literature and meta-analysis

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Abstract Fibroids may give rise to specific obstetrical com-plications such as pain due to degeneration, fetal malpresentation, or placenta previa. For all these reasons,
surgical resection of the fibroid may be indicated before a pregnancy is pursued. The occurrence of a uterine rupture is a rare but severe complication of myomectomy. This study seeks to review the risk of uterine rupture during pregnancy and/or labor after laparoscopic myomectomy in comparison with laparotomic myomectomy. A systematic search of the literature through search strategies in MEDLINE (PubMed) and Embase (Embase.com) from January 1970 up to March 2013was performed. We used the followingMeSH terms and
free text words: gynecologic surgical procedures, gynecologic surgery, leiomyoma, fibromyoma, fibroids, myoma, uterine tumors, and pregnancy complication. Our data show that the risk of uterine rupture during labor and delivery is low (0.75 %). Compared with traditional open myomectomy, the risk of uterine rupture during pregnancy is not significantly higher after a laparoscopic approach (P=0.119).More elective cesarean sections are performed after laparoscopic myomec-tomy compared with the conventional open technique (P= 0.001). Our conclusions are supported by statistical pooling of observational studies of generally low methodological quality. The risk of uterine rupture after myomectomy is low (0.75%). The available evidence in the literature does no allow discour-aging attempts for childbirth per viam naturalem after previ-ous myomectomy, regardless of the technique used. Randomized studies are needed before definitive evidence-based recommendations can be given.

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Judul Seri

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No. Panggil

Artikel

Penerbit

USA : Springer., 2014

Deskripsi Fisik

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Bahasa

English

ISBN/ISSN

DOI 10.1007/s10397-0

Klasifikasi

NONE

Tipe Isi

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Tipe Media

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Tipe Pembawa

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Edisi

Gynecol Surg (2014) 11:197–20

Subjek

Medicine
myomectomy
uterine rupture

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