Pregnancy After a Myomectomy: Why a C-Section Delivery Is Likely

Up to 80% of women get uterine fibroids — benign growths in the uterus — and a small fraction of those fibroids can lead to big problems. Pelvic pain, heavy periods, and pregnancy complications are just a few of the potential side effects associated with problematic fibroids.

Our ability to remove symptomatic fibroids — a procedure called a myomectomy — keeps improving thanks to advanced surgical techniques such as laparoscopy and the daVinci® robot-assisted surgical system.

Here at Advanced Endometriosis Center, our own Dr. Ulas Bozdogan is a leading expert in robotic and minimally invasive myomectomies. While you’re in good hands for your fibroid removal, it’s important to understand that any future pregnancies after this surgery may include a Cesarean section (C-section) delivery. We explain why below.

Myomectomies have come a long way, but…

Your uterus is an organ that features well-muscled walls that help with deliveries as well as your monthly periods. Called the myometrium, the muscles in these walls are strong (they push a baby out!), but potential weak spots can develop when we cut into them.

At Advanced Endometriosis Center, we specialize in robotic myomectomies, which represent significant advances from a few decades ago. Back then, when you had problematic fibroids, surgeons often removed your entire uterus because they didn’t have the tools or technology for more precision work.

Today, Dr. Bozdogan can expertly remove your fibroids while leaving your uterus healthy and intact. Still, he has to make small incisions in your uterine wall to excise the growths, and these incisions can compromise the integrity of your uterus.

This potential weakness is really only a concern when it comes to future pregnancies and deliveries. 

A very small chance of uterine rupture after a myomectomy

When we discuss the integrity of your uterus after a myomectomy, our real concern is uterine rupture during future pregnancies and deliveries. The risk is small — around a 1% chance that a woman will encounter a uterine rupture after a myomectomy — but it’s still enough for us to be concerned as this type of rupture can place you and your unborn child in danger.

This risk is about the same for women who’ve had a previous C-section — uterine rupture occurs in 1 out of every 300 deliveries in which there was a previous C-section.

As a result of these risks, many women opt for C-sections after their myomectomies to eliminate the threat of uterine rupture during late pregnancy or delivery. These C-sections are typically performed around weeks 37-38.

Who performs your myomectomy matters

As you might have surmised, the least amount of disruption in your uterus is best, and that’s why Dr. Bozdogan has embraced minimally invasive technologies.

Whether your fibroid(s) is fully involved and penetrates all layers of your uterus or it’s on the surface, Dr. Bozdogan keeps collateral damage of your myometrium to a minimum. 

What this means for future pregnancies depends on your comfort level and what your OB/GYN advises. Rest assured, we’re also here to advise you every step of the way.

While a C-section delivery after your myomectomy isn’t a foregone conclusion, it’s something you should plug into the equation moving forward.

If you want to learn more about why a C-section is often recommended after a myomectomy and whether this applies to you, schedule a consultation with Dr. Bozdogan today online or over the phone. We have offices in New York City and Paramus, New Jersey.

 

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