Et si nos myomectomies avaient aussi le droit à un accouchement par voie basse ? Résultats d’une étude monocentrique

Conclusion Cette étude semble montrer que l’accouchement par voie basse après myomectomie est possible avec un taux de réussite similaire à celui d’un utérus cicatriciel post-césarienne. Objective To compare delivery outcomes according to the scar: myomectomy versus low-segment transverse cesarean. Methods A retrospective cohort study was performed in a university type 3 service between 1st January 2006 and 1st January 2012. We compared 18 women who gave birth after myomectomy (exposed group) to 72 women who gave birth after cesarean section (non-exposed group). Women younger than 43 years who underwent laparotomy or laparoscopic myomectomy were included. The primary endpoint was the rate of vaginal delivery. The route of delivery, the rate of uterine rupture, complications of delivery and neonatal outcome were studied. Results The acceptance rate of vaginal delivery was 55.6% after myomectomies versus 84.7% after cesarean section (P =0.005). The success of vaginal birth was 88.9% after myomectomy versus 73.9% after cesarean (NS). No uterine rupture has occurred after myomectomy against three sub-peritoneal rupture after cesarean. The occurrence of post-partum hemorrhage was not significantly different between the 2 groups (11.1% among exposed group versus 6.9% in the non-exposed group). The cesarean section rate was even higher than the number of hysterotomy was great (P =0.0047). Conclusion This study seems to show that vaginal birth after myomect...
Source: Gynecologie Obstetrique and Fertilite - Category: OBGYN Source Type: research