Reflections on Postpartum Hysterectomy as a Possible Complication of Cesarean Myomectomy: A Long Debate

被引:1
作者
Tabakova, Nikoleta [1 ,2 ]
Sparic, Radmila [3 ,4 ]
Tinelli, Andrea [5 ,6 ]
机构
[1] Med Univ Varna, Dept Obstet & Gynecol, Marin Drinov St 55, Varna 9002, Bulgaria
[2] Obstet & Gynecol Hosp SBAGAL Varna, Varna 9000, Bulgaria
[3] Univ Belgrade, Fac Med, Belgrade 11000, Serbia
[4] Univ Clin Ctr Serbia, Clin Gynecol & Obstet, Belgrade 11000, Serbia
[5] Dept Obstet & Gynecol, I-73100 Scorrano, Lecce, Italy
[6] Veris Delli Ponti Hosp, CERICSAL Ctr Ric Clin SALentino, I-73100 Scorrano, Lecce, Italy
来源
MEDICINA-LITHUANIA | 2024年 / 60卷 / 04期
关键词
cesarean myomectomy; postpartum hysterectomy; cesarean section; pregnancy; labor; complications; UTERINE MYOMAS; PREGNANCY; LEIOMYOMATA; MANAGEMENT; FIBROIDS; DELIVERY; RUPTURE; RISK;
D O I
10.3390/medicina60040594
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Uterine fibroids are common benign tumors found in fertile women. Numerous obstetrical issues, such as dystocia during labor, fetal hypotrophy, a ruptured amniotic sac, early labor, low-birth-weight newborns, etc., are associated with fibrous pregnant uteri. Cesarean myomectomy is not a common procedure because of the possibility of postpartum hysterectomy or a potentially lethal hemorrhage. For the chosen topic, we present two instances of emergency postpartum hysterectomies following cesarean myomectomy. After a cesarean myomectomy, two women experienced a perioperative hemorrhage that required a postpartum hysterectomy without a salpingo-oophorectomy. A postpartum hysterectomy was required in every instance due to the failure of additional hemostatic techniques to control the bleeding after the cesarean myomectomy. In every case, the location and number of fibroids-rather than their size-were the primary factors leading to the postpartum hysterectomy. In order to ensure that the patient is safe and that the advantages outweigh the dangers, the current trends in cesarean myomectomy include aiming to conduct the procedure either electively or when it offers an opportunity. The treatment is still up for debate because it is unknown how dangerous a second hysterectomy is for people who have had a cesarean myomectomy.
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页数:10
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