Pregnancy after Laparoscopic Myomectomy – Long-term Follow up

Overview

Objective:
Analysis of pregnancy related complications in infertile patient after laparoscopic myometomy (LM).

Design:
Retrospective analytic study.

Setting:
Institute for the Care of Mother and Child, Prague; Institute for Postgraduate Medical Education, Prague.

Methods:
The study group were infertile patients referred to our department with the finding of uterine fibroid(s). In all patients LM was the method of choice. Thorough information and results from all infertile patient after LM were assessed and analysed with 18 months follow-up after surgery.

Results:
The aim of our study was to evaluate pregnancy rate and the possible risks during pregnancy and delivery following LM. We analysed 69 patients after LM. Mean size of a fibroid was 3.3 cm and the number of removed fibroids in one patient was 1.8. The conception rate after LM was 56.5%. We didn’t observe any increased incidence of fetomaternal morbidity or severe pregnancy and labour related complications. There was no uterine rupture after LM in our group. The cesarean section was rate 44.8%.

Conclusions:
The impact of fiborids on infertility is still controversial. LM in infertile patient is one of the most common surgical procedure. The appropriate surgical management of uterine scar is mandatory. This operation must be performed by skilled reproductive surgeon. Thorough information to the patient before and after LM is necessary. The pregnancy following LM is at high risk with increased caesarean section rate.

Key words:
laparoscopy, complication, uterine fibroid, myomectomy, infertility, pregnancy, uterine rupture, cesarean section