Subsequent pregnancy outcomes after abdominal vs. laparoscopic myomectomy

J Matern Fetal Neonatal Med. 2022 Dec;35(25):8219-8225. doi: 10.1080/14767058.2021.1967315. Epub 2021 Aug 17.

Abstract

Objective: To determine whether abdominal (open) vs. laparoscopic myomectomy affects the obstetrical outcomes of subsequent pregnancies.

Methods: A retrospective cohort study was conducted at a tertiary university medical center. The study population included women who had a documented birth following a myomectomy at our institution between the years 1997 and 2018. The obstetrical characteristics and immediate perinatal outcomes of the subsequent pregnancy following open vs. laparoscopic myomectomy were collected and compared. Data were retrieved from patients' medical records via the institutional computerized database. Cases that lacked detailed surgery and delivery reports were excluded. Data were analyzed using a chi-square test for categorical variables and one-way ANOVA for continuous variables. A p-value <.05 was considered statistically significant.

Results: During the study period, 57 women met the inclusion criteria, of whom 66.6% (38/57) had an open and 33.3% (19/57) had a laparoscopic myomectomy. Women who underwent an open myomectomy had a higher rate of cesarean birth than those in the laparoscopic group (89.5 vs. 42.1%, p < .001). No cases of severe maternal or perinatal complications, uterine ruptures, or placental abruptions were identified in either study group. No other significant differences were noted between the two types of myomectomy.

Conclusion: Open myomectomy is associated with a higher rate of cesarean delivery than laparoscopic. No severe adverse maternal or neonatal outcomes were detected in either study group.

Keywords: Myomectomy; abdominal (open) myomectomy; laparoscopic myomectomy; obstetric outcome; perinatal outcome; uterine rupture.

MeSH terms

  • Female
  • Humans
  • Infant, Newborn
  • Laparoscopy* / adverse effects
  • Leiomyoma* / complications
  • Placenta
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Retrospective Studies
  • Uterine Myomectomy* / adverse effects
  • Uterine Neoplasms* / complications