Can Uterine Fibroids Be Removed During Cesarean Section? - Obstetrics and Gynecology

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Uterine fibroids, also known as leiomyomas, are non-cancerous growths that can develop in the uterus. They are quite common and can vary in size, number, and location. When it comes to pregnancy and childbirth, the presence of fibroids can complicate matters, but they can often be managed effectively.

In your case, you are currently 12 weeks pregnant and have an 8 cm fibroid, along with a history of Mediterranean anemia. The question of whether fibroids can be removed during a cesarean section (C-section) is a nuanced one. Generally, it is possible to remove fibroids during a C-section, but there are several factors to consider.

1. Size and Location of the Fibroid: The size and location of the fibroid play a significant role in determining whether it can be safely removed during a C-section. An 8 cm fibroid is relatively large, and if it is located on the outer wall of the uterus (subserosal), it may be easier to remove. However, if it is intramural (within the uterine wall) or submucosal (just under the lining of the uterus), the surgical approach may be more complicated.

2. Risks Involved: Removing fibroids during a C-section can increase the risk of complications, such as excessive bleeding, infection, or damage to surrounding organs. Given your Mediterranean anemia, which can affect your blood's ability to carry oxygen, the surgical team would need to be particularly cautious about managing blood loss during the procedure.

3. Timing and Surgical Decision: The decision to remove fibroids during a C-section should be made collaboratively between you and your healthcare provider. It is essential to weigh the benefits of removing the fibroid against the potential risks. If the fibroid is causing significant symptoms or complications, such as pain or bleeding, it may be more justifiable to remove it during the C-section.

4. Postoperative Considerations: If the fibroid is removed, you will need to be monitored closely after the surgery for any signs of complications. Recovery may take longer if additional surgical procedures are performed during the C-section.

5. Consultation with Specialists: It is advisable to consult with both your obstetrician and a maternal-fetal medicine specialist. They can provide insights tailored to your specific situation, considering your pregnancy, the size and location of the fibroid, and your overall health.

In summary, while it is possible to remove uterine fibroids during a C-section, the decision should be made carefully, considering the potential risks and benefits. Your healthcare team will be the best resource for determining the safest and most effective approach for your delivery and any necessary interventions regarding the fibroid. Always ensure that you have open communication with your healthcare providers about your concerns and preferences as you approach your delivery date.