Pune Doctors Perform Rare Caesarean Myomectomy During Delivery

Doctors in Pune successfully executed a rare surgical procedure known as Caesarean Myomectomy on a mother during full-term delivery. This complex surgery involves the removal of fibroids from the uterus and is particularly challenging during pregnancy due to the significant risks it poses to both the mother and the fetus. The operation was conducted at Motherhood Hospital in Kharadi, highlighting a remarkable achievement in obstetric care.

Myomectomy, while necessary in certain cases, is classified as rare during pregnancy. Research indicates that fibroids impact approximately 2-4 percent of all pregnancies, yet surgical intervention is required in less than 0.5 percent of these cases. Most fibroids are typically monitored until after delivery unless they present severe complications.

At 37 weeks of gestation, the medical team, led by Dr. Mansi Sharma, an obstetrician and gynaecologist, carried out the planned surgery. The procedure involved both a Caesarean section and the removal of a significant intramural fibroid measuring 8 cm, which posed risks of heavy bleeding and other complications. The successful execution of the surgery resulted in the birth of a healthy baby and the safe extraction of the fibroid.

The case emphasizes the critical importance of antenatal check-ups, early diagnosis, and personalized care in managing high-risk pregnancies. The patient, identified as Radhika, a working professional in her early 30s, initially visited the hospital for a routine antenatal check-up. An ultrasound during this visit revealed the presence of the sizable fibroid and several smaller fibroids measuring between 1-2 cm.

Uterine fibroids occur in approximately 0.8-10 percent of all pregnancies, influenced by various factors including population demographics and diagnostic practices. Despite the presence of the large fibroid, Radhika’s pregnancy progressed without significant complications such as Intrauterine Growth Restriction (IUGR) or preterm labour. She did experience intermittent abdominal pain due to fibroid degeneration, a condition where the fibroid outgrows its blood supply and leads to tissue breakdown.

Dr. Sharma explained, “A myoma, or uterine fibroid, is a non-cancerous growth in or around the uterus, often influenced by hormonal changes. While common in women of reproductive age, large fibroids during pregnancy can lead to complications such as pain, fetal position issues, or delivery challenges. Surgery is typically avoided during pregnancy due to the increased risk of heavy bleeding, but in select cases, a Caesarean myomectomy may be necessary to ensure safe delivery for both mother and baby.”

As the pregnancy progressed into the third trimester, the fibroid caused cephalo-pelvic disproportion, preventing the baby’s head from descending into the pelvis. This condition necessitated a planned elective Caesarean section. During the procedure, the obstetric team not only delivered the baby safely but also successfully removed the 8 cm fibroid without any complications or need for blood transfusion.

Both mother and baby recovered well after the surgery. The smaller fibroids, which are likely to shrink postpartum due to hormonal changes, were left untreated. Dr. Sharma reiterated the importance of regular antenatal check-ups and timely diagnosis in managing high-risk pregnancies involving large fibroids. “Cesarean myomectomy remains a rare but necessary intervention in select cases where fibroids significantly impact delivery outcomes,” she noted.

Radhika expressed her gratitude to Dr. Sharma and the medical team, stating, “I’m truly grateful to Dr. Mansi Sharma for giving me the safest delivery I could have hoped for. Despite the fibroid, they ensured my baby was born healthy, and I came out of surgery without any complications. Their constant support and expert care made all the difference.”

This case exemplifies the advances in medical procedures and the critical role of specialized care in obstetrics, providing hope for similar cases in the future.