Abdominal versus laparoscopic myomectomy: does it affect subsequent pregnancy outcome?

Objective
To determine whether the abdominal (open) versus laparoscopic methods of myomectomy affect the obstetrical outcomes of subsequent pregnancies.
Study Design
A retrospective cohort study was conducted at a tertiary university medical center. The study population included women who had a documented birth following a myomectomy at our institution between the years 1997 and 2018. The obstetrical characteristics and immediate perinatal outcomes of the subsequent pregnancy following myomectomy were collected and compared between those who had open versus laparoscopic myomectomy. Data were retrieved from patients’ medical records via the institutional computerized database. Cases that lacked detailed surgery and delivery reports were excluded. Data was analyzed using a chi-square test for categorical variables and one-way ANOVA for continuous variables. A P-value < 0.05 was considered statistically significant.

Results
During the study period, 57 women met the inclusion criteria, of whom 66.6% (38/57) had open and 33.3% (19/57) had laparoscopic myomectomies. Women who underwent an open myomectomy had a higher rate of cesarean section than those in the laparoscopic group (89.5% vs. 42.1%, p<0.001). No cases of severe maternal or perinatal complications, uterine ruptures or placental abruptions were identified. No other significant differences were noted between the two types of myomectomy.
Conclusion
Open myomectomy is associated with a higher rate of cesarean delivery than laparoscopic. No adverse maternal or neonatal outcomes were detected in either study group.