Pregnancy And Delivery After Laparoscopic Myomectomy

Pregnancy And Delivery After Laparoscopic Myomectomy

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A Laparoscopic Myomectomy is a surgical procedure that involves the removal of uterine fibroids, also known as leiomyomas, which are noncancerous growths in the uterus, occurring commonly during childbearing year, but may also occur at any age. The main goal for the surgeon during a myomectomy is to remove the fibroids that are responsible for causing the symptoms and reconstruct the uterus.

What the Procedure Entails

This surgical procedure is performed usually as an out-patient one, under general anesthesia. In this procedure, the pelvic and abdominal organs are viewed by inserting a slender telescope through the navel. A few half-inch small incisions are made below the pubic hairline and the surgery is performed by passing the instruments through these tiny incisions. Patients can expect a quick recovery, only a short stay in the hospital and smaller scars due to the small size of these incisions.

Pregnancy & Delivery Post Laparoscopic Myomectomy

There are mixed opinions attached to whether a woman is able to have children after a laparoscopic myomectomy. Most concerns stem from the question if the uterus will be able to, in the future, sustain the stress of labor, after laparoscopic techniques have been used to cut and repair it. As compared to an abdominal myomectomy, the rate of women who have undergone pregnancy and delivery after a laparoscopic myomectomy is much lower. However, the uterine scar can heal just as well with a laparoscopic myomectomy as with myomectomy done by laparotomy.

Some women are reported to have successfully gotten pregnant and undergone a safe delivery after a laparoscopic myomectomy. A laparoscopic myomectomy has been known to increase certain risks during delivery if a patient becomes pregnant in the future. This is especially so if the surgeon performing the myomectomy had to make a deep incision in the uterine wall of a patient. That is why many physicians still suggest a Caesarean section just to be on the safe side, so as to curtail the stress of labor on the uterus and to avoid rupture of the uterus during labor.

Some Studies Show Safe Pregnancy and Delivery

Recently there have been several studies that have proven how safe and successfully a laparoscopic myomectomy can be for women who wish to get pregnant in the future. However, further studies are required to compare laparoscopic myomectomy and standard myomectomy with regard to labor, fertility, and delivery.

Risks Of Laparoscopic Myomectomy

While laparoscopic myomectomy has a low complication rate, there are a unique set of challenges attached to the procedure. Apart from childbirth complications, which are a common cause for concern with most patients who have undergone the surgery, other potential risks include excessive blood loss, a rare chance of hysterectomy and scar tissue. Women who are anemic are at a higher risk of suffering from issues related to blood loss and they may be recommended to build up their blood count before surgery. Sometimes, there may be bands of scar tissue that develop after the surgery. Sometimes, adhesions outside the uterus may cause nearby structures to get entangled and result in a trapped loop of intestine or a blocked fallopian tube. Adhesions that form inside the uterus may sometimes cause difficulties with fertility such as Asherman's syndrome or light menstrual periods. It is important to note that usually, laparoscopic myomectomy causes fewer adhesions than abdominal myomectomy. These risks may be mitigated when physicians suggest hormone treatment, the administration of iron supplements and hormone therapy to shrink fibroids.

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