Cesarean Myomectomy: A Case Report in Zainoel Abidin General Hospital, Banda Aceh

摘要

Uterine myomas are the most common pelvic tumors over the age of 30 and it is now more frequently seen as many women delaying childbearing which is the time for greatest risk of myoma growth. Myomectomy during cesarean section has traditionally been discouraged because of the risk of uncontrollable hemorrhage. But as more knowledge about it is gain throughout times, it can now give different decision regarding it. This is a one case report study in Zainoel Abidin General Hospital in Banda Aceh about cesarean myomectomy. Hopefully, it can improve skill and knowledge of medical staff in making a cesarean myomectomy decision, its complications and its post operative care. The case is about a 32 year old, gravida 3 para 2, Indonesian woman presented with postterm-pregnancy and 20 cm intra mural-uterine myoma. Cesarean myomectomy was done to her with little to none intraoperative hemorrhage. Post C-section we found complications shown by uterine atony, profuse bleeding seen at the drainage through the peritoneum and marked changes in hemoglobin value. It is then carefully evaluated and managed using extensive follow up, high dose oxytocin and blood transfusion . In conclusion, cesarean myomectomy is now considered by many not always as a hazardous procedure and can be performed in experienced hands, in a well equipped tertiary institution, with the advent of better anesthesia, with availability of blood, in selected patients and according to site and size of myomas. It is always important to have a good informed consent beforehand and post operative care of cesarean myomectomy.