TY - JOUR
T1 - Pregnancy Outcomes and Risk Factors for Uterine Rupture After Laparoscopic Myomectomy
T2 - A Single-Center Experience and Literature Review
AU - Koo, Yu Jin
AU - Lee, Jae Kwan
AU - Lee, Yoo Kyung
AU - Kwak, Dong Wook
AU - Lee, In Ho
AU - Lim, Kyung Taek
AU - Lee, Ki Heon
AU - Kim, Tae Jin
N1 - Publisher Copyright:
© 2015 AAGL.
PY - 2015
Y1 - 2015
N2 - Objective: To evaluate pregnancy outcomes after laparoscopic myomectomy (LSM), focusing on the risk of uterine rupture. Design: Retrospective cohort study (Canadian Task Force classification III). Setting: University hospital. Patients: Of 676 women who visited the obstetrics department for a pregnancy after undergoing LSM performed at the same center between 1994 and 2012, we included the 523 women who had follow-up through the end of pregnancy. Interventions: All patients underwent LSM, and their medical charts were retrospectively reviewed. Measurements and Main Results: Multiple myomas were removed in 35.2% of cases, intramural-type lesions occurred in 46.5% of cases, and the mean myoma diameter was 4.9 cm. Pregnancy outcomes after LSM included 400 (76.5%) full-term deliveries and 100 (19.1%) vaginal deliveries, with other adverse outcomes being no different than the general population. The mean interval between LSM and pregnancy was 14 months, and only 3 (0.6%) cases of uterine rupture occurred during pregnancy. In analysis, by reviewing the published cases of uterine rupture, we found that the mean diameter, myoma number and type, and the rate of uterine suture were similar between the ruptured cases and all of our cases of LSM. Conclusion: LSM can be safely used in women of reproductive age who want to become pregnant. Uterine rupture occurs in rare cases, regardless of myoma features, but further large-scale studies are required to ascertain the detailed effects of various surgical techniques.
AB - Objective: To evaluate pregnancy outcomes after laparoscopic myomectomy (LSM), focusing on the risk of uterine rupture. Design: Retrospective cohort study (Canadian Task Force classification III). Setting: University hospital. Patients: Of 676 women who visited the obstetrics department for a pregnancy after undergoing LSM performed at the same center between 1994 and 2012, we included the 523 women who had follow-up through the end of pregnancy. Interventions: All patients underwent LSM, and their medical charts were retrospectively reviewed. Measurements and Main Results: Multiple myomas were removed in 35.2% of cases, intramural-type lesions occurred in 46.5% of cases, and the mean myoma diameter was 4.9 cm. Pregnancy outcomes after LSM included 400 (76.5%) full-term deliveries and 100 (19.1%) vaginal deliveries, with other adverse outcomes being no different than the general population. The mean interval between LSM and pregnancy was 14 months, and only 3 (0.6%) cases of uterine rupture occurred during pregnancy. In analysis, by reviewing the published cases of uterine rupture, we found that the mean diameter, myoma number and type, and the rate of uterine suture were similar between the ruptured cases and all of our cases of LSM. Conclusion: LSM can be safely used in women of reproductive age who want to become pregnant. Uterine rupture occurs in rare cases, regardless of myoma features, but further large-scale studies are required to ascertain the detailed effects of various surgical techniques.
KW - Laparoscopic myomectomy
KW - Pregnancy outcome
KW - Uterine rupture
UR - http://www.scopus.com/inward/record.url?scp=84947054062&partnerID=8YFLogxK
U2 - 10.1016/j.jmig.2015.05.016
DO - 10.1016/j.jmig.2015.05.016
M3 - Article
C2 - 26012718
AN - SCOPUS:84947054062
SN - 1553-4650
VL - 22
SP - 1022
EP - 1028
JO - Journal of Minimally Invasive Gynecology
JF - Journal of Minimally Invasive Gynecology
IS - 6
ER -