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Role of Cesarean Myomectomy In Contemporary Practice PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "ROLE OF CESAREAN MYOMECTOMY IN CONTEMPORARY PRACTICE” by Dr. Priyanka Singh.

This medical PowerPoint presentation is about cesarean myomectomy, a surgical procedure performed during a cesarean delivery to remove uterine fibroids (also called myomas) that can cause complications during pregnancy and delivery. In contemporary practice, cesarean myomectomy is a relatively uncommon procedure, as most women with uterine fibroids are now treated with less invasive methods.

The decision to perform a cesarean myomectomy depends on the size, location, and number of fibroids, as well as the risk of complications during pregnancy and delivery. In general, if a fibroid is large and located near the cervix, it can obstruct the birth canal and prevent a vaginal delivery, making cesarean myomectomy necessary.

However, cesarean myomectomy is associated with increased risks of bleeding, infection, and uterine rupture compared to a routine cesarean delivery. Therefore, it should only be performed by experienced obstetricians and in a setting with adequate resources to manage potential complications.

In contemporary practice, most women with uterine fibroids are managed with medical or minimally invasive procedures, such as hormonal therapy, uterine artery embolization, or laparoscopic myomectomy. These methods are associated with lower risks of complications and faster recovery times compared to cesarean myomectomy.

In summary, while cesarean myomectomy can be a useful option for select women with large, obstructing fibroids, it is generally considered a less preferred option in contemporary practice due to its increased risks and the availability of less invasive alternatives.

Tags : cesarean myomectomy, cesarean delivery, uterine fibroids, myomas, pregnancy, delivery, uterine fibroids, Obstetrics and Gynecology, Obstetrics and Gynecology PowerPoint presentation

Published on : Jun 20, 2023 | Views : 1341 | Downloads : 1

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Slide 1-

ROLE OF CESAREAN MYOMECTOMY IN CONTEMPORARY PRACTICE Dr. Priyanka Singh JR1, Department of obstetrics & gynecology Recent advances in neuraxial analgesia
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VICTOR BONNEY HIS VIEWS 1872 - 1953
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VICTOR BONNEY HIS VIEWS X 1872 - 1953
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CASEREAN MYOMECTOMY not to do Recent advances in neuraxial analgesia
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Why?
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What are the beliefs today? Changed – can be performed concurrently at the time of CS in selected cases. Keeping the basic principle of medicine in consideration
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What are the beliefs today? Only those fibroids to be removed Which will require surgery later Are easy to remove Four cases of pregnancy with fibroid
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Case 1 36 weeks of pregnancy, primigravida Referred - large fibroid with malpresentation Married for six years, spontaneous conception Examination – term uterus with fetus in oblique position and large anterior fibroid. Elective CS after consent for myomectomy and hysterectomy Male baby delivered. Uterus exteriorised after suturing the uterine incision.
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Large anterior wall fibroid Myomectomy appeared feasible. Performed myomectomy after liberal infiltration of diluted vasopressin. Cavity was obliterated Postoperatively – uneventful.
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Case 2 38 weeks of gestation, a booked case On examination longitudinal lie with high floating head. A mass was felt in lower segment on left side. Unfavourable cervix. USG
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Case 2 38 weeks of gestation, a booked case On examination longitudinal lie with high floating head. A mass was felt in lower segment on left side. Unfavourable cervix. USG
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Case 2 Underwent elective CS. Explained about myomectomy at the time of CS. After uterine closure A big fibroid was seen on left side of broad ligament with large blood vessels running over the fibroid. Myomectomy not performed Location High vascularity Postoperative period uneventful
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Case 3 38 weeks of gestation, admitted for elective CS for breech presentation. USG - 11 cm 12 cm size fibroid on right side of uterus on its main body. Elective CS followed by myomectomy of subserosal fibroid. Postoperative period was uneventful.
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Case 4 Referred as fundal height was more. Examination - uterus up to xiphisternum, fetus in longitudinal lie USG Three large fibroids, one anteriorly in the lower part and two in the upper fundal region. Spontaneous labour, fetal bradycardia first stage. Emergency CS done. Uterine incision was closed in two layers. Three large fibroids
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Case 4 Total weight of three fibroids was 1.8 Kg. Postoperatively she made uneventful recovery.
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Role of Vasopressin?
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Final Summary Management of fibroids during antenatal period is never surgical except torsion of pendculated fibroid. Fibroids in pregnancy are common and incidence will increase in future. Myomectomy at CS is not absolutely CONTRAINDICATED as believed earlier. Decision depends on location, size and number.
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Final Summary Enucleation is easier. Preoperative counseling and consent. Decision should be case to case basis. Management at tertiary care hospital.
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Final Message Risk and Benefits to be evaluated in every case and decision individualized.
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Thank you