부산대학교 도서관

The proper management of uterine leiomyomas found during cesarean section remains uncertain. Some obstetricians believe that myomectomy is safe in carefully selected cases, but others continue to discourage the practice because of the risk of intractable bleeding. Uterine artery occlusion may provide an alternative. This prospective nonrandomized study evaluated ligation in 48 women with uterine leiomyomas, including at least one larger than 5 cm, who underwent cesarean section for obstetrical reasons. Approximately 60% of patients had multiple myomas. Twenty-six women (group I) had ligation of both uterine arteries immediately after closing the uterine incision, while 22 (group II) served as a control group. In study cases the uterine arteries were double-ligated with silks. Women in the study and control groups were similar with respect to age, parity, gestational age, myoma size, position of the dominant myoma, indications for cesarean delivery, and preoperative hemoglobin values. The average postoperative follow-up was 38.5 months.