Cesarean myomectomy for large uterine fibroids: Surgical outcomes from a single-center case series.

To evaluate the safety and feasibility of cesarean myomectomy in patients with fibroids greater than 5 cm. This was a retrospective case series of 45 patients undergoing cesarean delivery with concurrent myomectomy for fibroids >5 cm at a tertiary care center. Primary outcomes included operative time, estimated blood loss (EBL), hemoglobin drop, transfusion rates, and postoperative complications. Mean operative time was 74 min. On average, 2.5 fibroids were removed, with the largest averaging 10.1 cm in diameter. The mean hemoglobin drop was 2.5 g/dL, significantly associated with fibroid size. Average EBL was 827 mL. No patients required intraoperative transfusion, and only 4.4% required postoperative transfusion. Complication rates were comparable to standard cesarean delivery. Cesarean myomectomy for larger fibroids is feasible and safe within experienced surgical programs, allowing patients to avoid additional surgery without significantly increased risk.