FERTILITY OUTCOME AFTER ABDOMINAL MYOMECTOMY

Background and Objectives: Uterine lieomyomata are one of the causes of female infertility. Surgical excision of these tumour may improve the fertility outcome in these females. The present study was conducted to evaluate the role of myomectomy on fertility after abdominal surgery and to see the influence of the number, size, and location of uterine Leiomyomas pertaining to fertility outcome after the surgery. Methods: It was a descriptive cross sectional study, carried out in the department of obstetrics and gynecology Lady Willingdon Hospital from January 2008 – December 2011. A total of 30 patients of abdominal myomectomy were included. The women were 25 – 40 years of age with submucousal and intramural fibroids of varying size ranging from 4 cm to 20 cm. Myomectomy was performed in all patients by enucleating all fibroids. Results: Uterine cavity was opened in 11 patients (36.6%). Out of thirty patients, 19 patients (63%) conceived spontaneously within 12 – 24 months. There were no spontaneous abortions. Eleven patients failed to conceive yet, two of which found to have bilateral tubal occlusion. Remaining nine patients require further follow-up. Out of 19 pregnancies, 3 were pre-term deliveries (15.8%). One patient delivered vaginally (5.3%).18 patients were delivered by caesarean section (94.7%).Three patients had malpresentations (15.8%) and two had post-partum hemorrhage (10.5%). Operative blood loss ranged from 1600 ml – 2500 ml. hospital stay was between 5 – 7 days.Conclusion: The reproductive outcome was improved after abdominal myomectomy.