Caesarean myomectomy.

This study was conducted at Korle Bu Teaching Hospital and Family Health Hospital, Accra, Ghana, between April 2000 and January 2001 to compare the efficacy and safety of myomectomy done at caesarean section with the application of a tourniquet with caesarean section without myomectomy. Twenty four patients were recruited into the study. Average haemoglobin of patients both pre and post-operatively was 11.73 g/dl and 9.90 g/dl for patients who had caesarean section with myomectomy and 12.07 g/dl and 10.34 g/dl in the other group in which caesarean section without myomectomy was performed. The average duration of operation was longer in patients who had caesarean section and myomectomy (62.08 mins) than those who had caesarean section alone (50.83 mins). The drop in average haemoglobin for patients who had caesarean section and myomectomy was 1.83 while those who had caesarean section alone was 1.73. This was not significant. The fibroid nodules removed ranged from one solitary nodule to six nodules with an average diameter of 6 cm. Eighty five per cent of the fibroids were intramural and in the body of the uterus. Uterine involution was normal and there were no significant complications during the puerperium. We conclude that there is no significant difference in intra-operative and post-operative morbidity and blood loss in performing caesarean section alone and caesarean section with myomectomy when a tourniquet is applied.