Unavoidable myomectomy during cesarean section: a case report

Since myomectomy throughout cesarean delivery may lead to hemorrhage and uterinal atony, it is not recommended. But, myomectomy has been reported during cesarean section in recent studies. We presented a patient with large intramural myoma who was diagnosed at 34 weeks of pregnancy and operated with an unavoidable cesarean-combined myomectomy. A 33-year-old unpursued primigravida was referred to emergency department with abdominal pain and amenorrhea of 34 weeks duration. A sonographic diagnosis of myoma in pregnancy was made. Cesarean section was required for fetal distress and alive 2300 g weighted male infant with Apgar score of 6 at one minute, was born. As uterine incision could not be closed because of the myoma, myomectomy was performed during cesarean section unavoidably. A single 970 g and 15 × 18 cm sized myoma was removed. The physical examinations were unremarkable in the postoperative period. Although there are case series that have demonstrated the safety of myomectomy during cesarean section, we concluded that myomectomy during cesarean section is not a safe procedure accept inevitable situations.