Tuesday, June 2, 2015

Laproscopic Myomectomy

When I decided to try for a VBAC, I had to do a lot of research to prepare myself.  I wanted to make sure I understood what the risks were (both for VBAC and C-section).  This was made more difficult by my lack of surgical report, but I was able to piece together my history using my surgery video from 1997, plus talking to a doctor who was actually willing to review my video with me. This is what I learned about my history: Laproscopic Myomectomy - 1997

  • Intramural fibroid
  • 4-5 cm
  • Left side of uterus - cornua - near tubal opening
  • Removal went into the wall, but did not enter the uterine cavity
  • Suturing done laproscopically 

  • C-section - 2010

    • Low transverse 
    • After first c-section, doctor said no visible scar at the cite of Laproscopic Myomectomy

    C-section 2013

    • Low transverse 
    I then had to research medical statistics and findings.  My favorite databases were pubmed, ebscohost, proquest, and google scholar.  I was able to run searches in these databases using keywords like:
    • Laparoscopic myomectomy 
    • Uterine rupture
    • Vaginal delivery 
    • Vaginal birth
    • VBAC
    • VBA2C
    • Cesarean
    • C-section
    • Uterine scar
    • Delivery outcome

    I found a lot of great articles, even some newer articles that have been wonderful for my understanding of the risks and making informed decisions.  Here are a few articles I've found:
    • "Evaluation of factors contributing to uterine scar formation after laparoscopic myomectomy" by Jun Kumakiri, et. al., ACTA Obstetricia et Gynecologica Scandinavica, Vol 89, Issue 8, p 1078-1083 (Aug. 2010) (PubMedWiley)
    • "Prospective comparison of delivery outcomes  of vaginal births after cesarean section versus  laparoscopic myomectomy" by Makino S, Tanaka, et. al., Journal of Obstetrics and Gynaecology Research, Vol 34, Issue 6, p 952-956 (Dec 2008) (PubMed, Wiley)
    To read these articles, check at your local library to see if they subscribe to the articles the articles are published in.  If they do not, request through your local library's interlibrary loan!  A reference librarian will be able to help you!

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