Obstetric and delivery outcome of pregnancies achieved after laparoscopic myomectomy

Abstract

Objective: To assess the risks and outcome of pregnancies and deliveries after laparoscopic myomectomy (LM).

Design: Retrospective study.

Setting: Center of Reconstructive Pelvic Endosurgery, Reproductive Medicine Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.

Patient(s): A total of 514 patients of fertile age that underwent LM at the Center were selected.

Intervention(s): All the surgical procedures were performed using the same technique employing a vertical uterine incision and avoiding the use of electrosurgery.

Main outcome measure(s): Number and outcome of pregnancies achieved after surgery, abortion rate, preterm delivery, gestational age, malpresentation, spontaneous or cesarean delivery, and postpartum hemorrhage. We also paid particular attention to the occurrence of uterine rupture.

Result(s): A total of 158 pregnancies were achieved. There were 43 (27.2%) spontaneous abortions, 4 (2.6%) ectopic pregnancies, and 1 (0.6%) therapeutic abortion. Only 27 patients (25.5%) had vaginal deliveries, whereas 79 (74.5%) underwent cesarean section. No instances of uterine rupture were recorded.

Conclusion(s): Our preliminary results confirmed that LM, performed by an expert surgeon, can restore reproductive capacity, allowing patients to have a successful pregnancy.