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Year : 2018  |  Volume : 12  |  Issue : 1  |  Page : 33-36

A comparative study of blood loss during caesarean myomectomy and caesarean section

Department of Anaesthesiology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

Correspondence Address:
Bright Ighodaro Obasuyi
Department of Anaesthesiology, University of Port Harcourt Teaching Hospital, Port Harcourt
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/phmj.phmj_17_17

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Background: Uterine enlargement and associated increase in its vascularity during pregnancy are believed to increase the risk of haemorrhage and thus caesarean myomectomy is often avoided. However, some reports have claimed that caesarean myomectomy is safe during caesarean section. Aim: This study aims to compare blood loss during caesarean myomectomy and caesarean section with a view to determine the safety of carrying out a caesarean myomectomy. Methods: A retrospective review of all parturient that had caesarean myomectomy (study group) or caesarean section (control group) in a Cottage Hospital in the Niger Delta from September 2011 to August 2012 was carried out. The patients with incomplete data, those with previous abdominal surgery and placental disease and emergency caesarean section were excluded from the study. Data were collated on intraoperative blood loss, intraoperative blood transfusion and packed cell volume (PCV) change. Data were analysed using the SPSS version 16.0 software. Results: There was no statistical difference in the mean age of the parturient in the study (31.3 ± 3.9 years) and control (30.9 ± 3.4 years; P = 0.72) groups. The mean estimated blood loss between the study group (670.8 ± 227.9 ml) and control group (575.0 ± 226.5 ml) was not statistically significant (P = 0.15). However, the PCV change between the study group (7.5% ±3.4%) and control group (5.2% ±2.9%) was statistically significant (P = 0.002), with a higher incidence of post-operative anaemia observed in the study group (P = 0.035). Conclusion: Caesarean myomectomy significantly increases the risk of intraoperative blood loss which can easily be underestimated, resulting in undertransfusion and anaemia with its associated complications. Caesarean myomectomy should, therefore, be carried out when benefits outweigh the risk and appropriate precaution should be put in place to manage possible intra- and post-operative anaemia.

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