P-35 A five-year retrospective analysis comparing morbidity and mortality outcomes of previous myomectomy surgical delivery, and elective repeat caesarean section
Author(s):
M Bailey , V DaCosta , M Reid
Year of Presentation:
2025
Objective: The objective of this study was to determine the
differences in maternal and neonatal morbidity between 2
groups of women, who have had a previous myomectomy,
Group1, (n=69), women who had an elective caesarean section (n=92), Group 2, who were all delivered by a current
caesarean section.
Methods: One hundred and fifty-eight women were enrolled consecutively from the labour ward booklist at the University Hospital during 2015 -2020. Women who had a stillbirth or delivered vaginally were excluded from this study. Demographic data and maternal and foetal outcomes were collected from eligible patient records. Postpartum haemorrhage (PPH) at caesarean section was defined as a blood loss of 1000mls or higher. The study was approved by the UWI Mona Ethics Research Committee.
Results: The mean age (sd) of Group 2, 34.1 (4.4) years was significantly lower than Group1 36.6(4.1) years. The prevalence of post-partum haemorrhage in the sample was 16.5% with significant higher blood loss in Group 1 vs Group 2 (geometric means with 95%CI; 679(573,804) vs 466(418,520), p<0.001). This difference remained significant after adjusting for surgical complications, gravidity, adhesions and mode of anaesthetic delivery. Specifically, women in Group 2 had 91% lower odds for PPH compared with Group 1. The APGAR score at 1 minute was significantly greater in Group 2 compared to Group 1 (8.3(1.5) vs 7.7(2.1), p=0.032) but there was no difference for other neonatal variables.
Conclusion: There was overall a low maternal and neonatal morbidity associated with women who have had a previous myomectomy, or previous caesarean section. Notwithstanding PPH is a concern and therefore strategies to mitigate PPH in these set of women are required.