{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T15:22:01Z","timestamp":1787930521545,"version":"build-2784847793"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>To evaluate the influence of myoma characteristics on cesarean myomectomy and to demonstrate its additional advantages.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Retrospective data were collected from 292 women with myomas who had undergone cesarean section at Kangnam Sacred Heart Hospital between 2007 and 2019. We performed subgroup analysis according to the type, weight, number, and size of myomas. Preoperative and postoperative hemoglobin levels, operative time, estimated blood loss, length of hospital stay, incidence of transfusion, uterine artery embolization, ligation, hysterectomy, and postoperative complications were compared among subgroups.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>There were 119 patients who had cesarean myomectomy and 173 who had cesarean section only. An increase in postoperative hospitalization and operation time was observed in the cesarean myomectomy group compared to that in the caesarean section only group (mean difference, 0.7 days, <jats:italic>p<\/jats:italic> = 0.01, 13.5 minutes, <jats:italic>p<\/jats:italic> &lt;0.001). Estimated blood loss, hemoglobin differences, and transfusion rates were higher in the cesarean myomectomy than in the cesarean section only group. There were no differences in postoperative complications (fever, bladder injury, and ileus) between the two groups. No hysterectomy cases were reported in the cesarean myomectomy group. In subgroup analysis, the larger and heavier the myoma, the higher the risk of bleeding that led to transfusion. Estimated blood loss, differences in hemoglobin, and transfusion rate increased depending on myoma size and weight. A significant increase in postoperative hospitalization was observed in women with larger and heavier myomas. However, there was no statistical difference among the three types of myomas.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>In cesarean myomectomy, larger (\u2265 10 cm), and heavier myomas (\u2265 500 g), were associated with postoperative outcomes, but not the number or type of myoma. The safety of cesarean myomectomy is not inferior to that of caesarean section only, considering its positive effects such as gynecological symptom relief and avoidance of the next surgery.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0280953","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T18:52:51Z","timestamp":1678387971000},"page":"e0280953","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Risk factors based on myoma characteristics for predicting postoperative complications following cesarean myomectomy"],"prefix":"10.1371","volume":"18","author":[{"given":"Young-Eun","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4199-5011","authenticated-orcid":true,"given":"Suyeon","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keun-Young","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1030-0096","authenticated-orcid":true,"given":"Ji-Eun","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,3,9]]},"reference":[{"key":"pone.0280953.ref001","first-page":"7576934","article-title":"Outcomes of Myomectomy at the Time of Cesarean Section among Pregnant Women with Uterine Fibroids: A Retrospective Cohort Study","volume":"2019","author":"R Zhao","year":"2019","journal-title":"Biomed Res Int"},{"issue":"12","key":"pone.0280953.ref002","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1111\/jog.13437","article-title":"Myoma and myomectomy: Poor evidence concern in pregnancy","volume":"43","author":"GN Milazzo","year":"2017","journal-title":"J Obstet Gynaecol Res"},{"issue":"5","key":"pone.0280953.ref003","doi-asserted-by":"crossref","first-page":"399","DOI":"10.7863\/jum.1994.13.5.399","article-title":"Natural history of uterine leiomyomas in pregnancy","volume":"13","author":"N Strobelt","year":"1994","journal-title":"J Ultrasound Med"},{"key":"pone.0280953.ref004","first-page":"121","article-title":"Cesarean Myomectomy\"; Remarks on the Operation","author":"B V","year":"1914","journal-title":"Proc R Soc Med"},{"issue":"9","key":"pone.0280953.ref005","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1080\/14767058.2016.1205024","article-title":"Cesarean myomectomy trends and controversies: an appraisal","volume":"30","author":"R Sparic","year":"2017","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"5","key":"pone.0280953.ref006","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1111\/jog.13294","article-title":"Cesarean myomectomy in modern obstetrics: More light and fewer shadows","volume":"43","author":"R Sparic","year":"2017","journal-title":"J Obstet Gynaecol Res"},{"issue":"11","key":"pone.0280953.ref007","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1055\/s-0043-120918","article-title":"Outcome of Cesarean Myomectomy: Is it a Safe Procedure","volume":"77","author":"MB Senturk","year":"2017","journal-title":"Geburtshilfe Frauenheilkd"},{"issue":"6","key":"pone.0280953.ref008","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1097\/AOG.0000000000002342","article-title":"Perioperative Complications of Cesarean Delivery Myomectomy: A Meta-analysis","volume":"130","author":"V Pergialiotis","year":"2017","journal-title":"Obstet Gynecol"},{"issue":"5","key":"pone.0280953.ref009","doi-asserted-by":"crossref","first-page":"367","DOI":"10.5468\/ogs.2014.57.5.367","article-title":"The safety of cesarean myomectomy in women with large myomas","volume":"57","author":"DH Kwon","year":"2014","journal-title":"Obstet Gynecol Sci"},{"issue":"2","key":"pone.0280953.ref010","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1007\/s00404-014-3239-z","article-title":"Is uterine myomectomy a safe option during cesarean section","volume":"290","author":"TH Kim","year":"2014","journal-title":"Arch Gynecol Obstet"},{"key":"pone.0280953.ref011","doi-asserted-by":"crossref","unstructured":"AR. 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A, A. O, A. D-M. Fertility and obstetric outcome after caesarean myomectomy. J obstet Gynaecol. 2008;28(7):710\u20132.","DOI":"10.1080\/01443610802462712"},{"issue":"1","key":"pone.0280953.ref023","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.fertnstert.2011.10.009","article-title":"Adverse obstetric outcomes associated with sonographically identified large uterine fibroids","volume":"97","author":"VI Shavell","year":"2012","journal-title":"Fertil Steril"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0280953","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T18:53:14Z","timestamp":1678387994000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0280953"}},"subtitle":[],"editor":[{"given":"Guglielmo","family":"Stabile","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,3,9]]},"references-count":23,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3,9]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0280953","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,9]]}}}