After a woman has fibroids removed by “keyhole” surgery, her chances of having a successful pregnancy and a term delivery are good, Italian researchers report. This approach is relatively safe in the hands of expert surgeons, they say.
In the medical journal Fertility and Sterility, Dr. Renato Seracchioli and colleagues report a high success rate among 158 pregnancies achieved after a total of 514 laparoscopic fibroid surgeries performed at the University of Bologna.
In this study, the average age of the women was 34 years when they underwent removal of fibroids. More than half of them had at least three fibroids of 5 centimeters or larger.
The average time for the women to conceive after surgery was 18 months.
The miscarriage rate was 27 percent, with most occurring during the first trimester, which is similar to other reports on laparoscopic fibroid surgery, but higher than the spontaneous abortion rate of 10 percent to15 percent seen in the general population.
There were no cases of uterine rupture, which is the most serious complication seen with pregnancy after surgery on the uterus.
Overall, there were 106 deliveries, with a high rate of cesarean section (75 percent). Most of these were elective, and not necessitated by complications. The researchers speculate that is was probably due to a “defensive attitude toward the birth process which is perhaps not necessary.” However, they point out that they are surgeons, not obstetricians, and did not closely follow the pregnancies.
Based on these preliminary results, Seracchioli and colleagues say, laparoscopic fibroid removal “gives the possibility not only to restore reproductive capacity, but also to enable the patient to take a pregnancy to a successful conclusion.”
SOURCE: Fertility and Sterility, July 2006.