caa a22 4500 445308028 CHVBK 20180317142619.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s00404-010-1460-y doi (NATIONALLICENCE)springer-10.1007/s00404-010-1460-y Relative morbidity of abdominal myomectomy for very large uterine fibroids in a developing country hospital [Elektronische Daten] [Olufemi Oladapo, Akinwunmi Akinsanya] Background: Data on comparative outcomes of abdominal myomectomy for varying uterine sizes that could guide informed decision by women and clinicians in resource-constrained settings are scarce. Objective: To evaluate safety of abdominal myomectomy and compare perioperative morbidities for women with very large uterine size (≥20weeks) with that of women with smaller uterine size (<20weeks) in a developing country hospital. Methods: Retrospective and comparative chart review of 224 women with uterine sizes between 12 and 36weeks who had abdominal myomectomy performed at a Nigerian university hospital. Primary outcome measure was overall perioperative morbidity, with the following secondary outcomes: hemorrhage, febrile morbidity, unintended major surgical procedures, life-threatening events, and rehospitalization (according to validated criteria). Other variables included operating time, estimated blood loss, wound complications and postoperative hospital stay. Results: Overall morbidity occurred in 31.7% of women with hemorrhage (20.5%) and febrile morbidity (16.1%) being leading contributors. Unintended procedures (0.9%) and life-threatening events (1.8%) were rare and no death was recorded. Forty women (17.9%) had blood loss≥1l and 11.6% received homologous blood transfusion. Overall morbidity and all secondary morbidity outcomes (according to predefined criteria) were comparable between women with very large uterine size and those with smaller uteri. However, the mean blood loss was significantly more and the procedure and average hospital stay were significantly longer in women with very large uterine size. Conclusion: Abdominal myomectomy in this setting is associated with significant but acceptable perioperative morbidity. Increased uterine size does not significantly affect clinically important morbidities and women with very large uterine size should not be denied this procedure for safety concerns. Springer-Verlag, 2010 Fibroid nationallicence Leiomyoma nationallicence Myoma nationallicence Myomectomy nationallicence Operative morbidity nationallicence Low resource setting nationallicence Oladapo Olufemi Maternal and Fetal Health Research Unit, Department of Obstetrics and Gynecology, Olabisi Onabanjo University Teaching Hospital, P.M.B. 2001, Sagamu, Ogun State, Nigeria aut Akinsanya Akinwunmi Maternal and Fetal Health Research Unit, Department of Obstetrics and Gynecology, Olabisi Onabanjo University Teaching Hospital, P.M.B. 2001, Sagamu, Ogun State, Nigeria aut Archives of Gynecology and Obstetrics Springer-Verlag 283/4(2011-04-01), 825-830 0932-0067 283:4<825 2011 283 404 https://doi.org/10.1007/s00404-010-1460-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00404-010-1460-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Oladapo Olufemi Maternal and Fetal Health Research Unit, Department of Obstetrics and Gynecology, Olabisi Onabanjo University Teaching Hospital, P.M.B. 2001, Sagamu, Ogun State, Nigeria aut NATIONALLICENCE 700 1- Akinsanya Akinwunmi Maternal and Fetal Health Research Unit, Department of Obstetrics and Gynecology, Olabisi Onabanjo University Teaching Hospital, P.M.B. 2001, Sagamu, Ogun State, Nigeria aut NATIONALLICENCE 773 0- Archives of Gynecology and Obstetrics Springer-Verlag 283/4(2011-04-01), 825-830 0932-0067 283:4<825 2011 283 404 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer