Impact of Laparoscopic Myomectomy on Pregnancy Outcomes: A Retrospective Review

Abstract

Background: Uterine fibroids are the most common benign tumors of the female
reproductive tract, affecting fertility and pregnancy outcomes. Laparoscopic
myomectomy has emerged as a minimally invasive treatment option for women with
symptomatic fibroids who wish to preserve fertility. This study aimed to evaluate the
impact of laparoscopic myomectomy on pregnancy outcomes in women with a
history of uterine fibroids.
Methods: This retrospective study reviewed 35 patients who underwent laparoscopic
myomectomy at the Department of Obstetrics and Gynecology, KVG Medical
College and Hospital, Sullia between June 2023 and May 2024. Women of
reproductive age (18-45 years) with confirmed diagnoses of uterine fibroids who
underwent laparoscopic myomectomy and desired fertility were included.
Demographic data, surgical outcomes, and pregnancy outcomes (conception rates,
miscarriage rates, preterm delivery rates, and mode of delivery) were collected for a
minimum follow-up period of 12 months post-surgery.
Results: The mean age of participants was 34.6 ± 5.2 years with a BMI of 26.4 ± 4.1
kg/m². The average number of fibroids removed was 2.3 ± 1.5, with the largest
fibroid measuring 6.8 ± 2.4 cm. Most fibroids were intramural (51.4%), followed by
subserosal (34.3%) and submucosal (14.3%). Mean operative time was 92.5 minutes
with an estimated blood loss of 150.3 mL and hospital stay of 1.8 days. The
conception rate was 11.4% (4/35) with a mean time to conception of 8.2 months. The
miscarriage rate was 25% (1/4) and preterm delivery rate was 33.3% (1/3). Among
deliveries, 66.7% (2/3) were vaginal and 33.3% (1/3) were cesarean sections. The
mean gestational age at delivery was 36.7 weeks. Subgroup analysis based on fibroid
location showed no statistically significant differences in pregnancy outcomes.
Conclusion: Laparoscopic myomectomy appears to have a positive impact on
pregnancy outcomes in women with uterine fibroids. While our findings show
conception rates, successful vaginal delivery rates, and pregnancy complication rates
comparable to previous studies, the retrospective design, small sample size, and lack
of a control group necessitate larger prospective studies to confirm these findings and
assess long-term outcomes.