الفهرس 
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Abstract
Introduction: Uterine fibroids are the most common benign tumors occurring during the reproductive age. The incidence of fibroid during pregnancy is from 1.6 to 10.7 % and it is probably increasing due to the delay in child bearing. They may adversely affect pregnancy dependimg on their site and size. In the past myomectomy during cesarean section was discouraged due to the risk of hemorrhage which may need hysterectomy and post- operative morbidity. Recently, this procedure has become safer and more feasible as regard many studies. Aim of this study: to prove the safety of myomectomy during cesarean section with proper case selection. Patients and methods: This descriptive study was conducted in Mansoura University Hospital and included 50 women who underwent cesarean myomectomy after documented consent . The procedure was evaluated as regard the site and size of myomas, blood loss, need for blood transfusion, hemostatic measures, changes in hemoglobin and hematocrite values, duration of surgery, post operative morbidity and neonatal outcome. Blood loss was controlled by continuous oxytocin infusion, tranexamic acid, electro-cautery, uterine artery ligation and internal iliac ligation Results: In this study the mean gestational age at delivery was 37 weeks. 26 cases had sub serous myomas, 18 had intramural and 6 had submucous myomas. 38% of the cases had myomas 5 cm . 70 % of the studied cases did not need blood transfusion . The mean blood loss was 1695 ml . 70% of studied cases had 2-3 or more days postoperative hospital stay, 7 cases had postpartum hemorrhage and 8 cases had postoperative fever. Hysterectomy was not done for any case to control hemorrhage. By analyzing and processing the data obtained from the history and evaluation, our study declared that: Planned cesarean myomectomy is safe if performed by an experienced obstetrician with proper controlling of blood loss, but it may prolong the operative time and postoperative hospital stay. It also has many benefits including avoiding another operation to remove fibroids.