Q: Cesarean section (c-section) or not after myomectomy?

A: During a myomectomy, one or many incisions are made into the uterus, the myoma is cut out, and the defects are sutured. After a myomectomy there is an increased risk of uterine rupture during pregnancy because of scarring in the uterus. That's why many doctors suggest doing a cesarean section before labor in women who've had a myomectomy, because it usually prevents uterine rupture. The risk of uterine rupture after a myomectomy depends on:

  • How extensive the myomectomy was (that is, how big was the myoma, how many were there)
  • How extensive the repair was
  • Where the myomectomy was (that is, fundal, anterior, posterior)
  • How deep the incision into the uterus (the myometrium) was
  • Whether it was done by laparoscope or not

The doctor who performed the surgery can provide the best information on this risk.