Abstract: Objective To explore the clinical outcomes of cesarean myomectomy (CM) in pregnant women with different types of uterine myomas. Methods A retrospective cohort study of 246 singleton pregnancies with different types of uterine myomas underwent cesarean section and CM was performed. There were subserosal myomas (SM) group (135 cases) and intramural myomas (IM) group (111 cases) according to the different types of uterine myomas. The clinical characteristics and delivery outcomes were analyzed. Results ① In IM group, the maternal age,the proportion of myomas(≥5 cm)and the proportion of multiple myomas were significantly higher than those in SM group (37 years vs 34 years, χ²=-3.640, P=0.000; 50.5% vs 25.9%, χ² =15.719, P=0.000; 55.0% vs 23.0%, χ² =26.630, P=0.000). ② In IM group, the operation time and the proportion of using additional oxytocin were higher than those in SM group significantly (50 min vs 45 min, Z=-3.349, P=0.001; 49.5% vs 29.6%, χ² =10.197, P=0.001). In IM group, blood loss ≥500 mL and the blood loss increased significantly than that in SM group (47.7% vs 33.3%, χ² =5.281, P=0.022; 530 mL vs 400 mL, Z=-3.247, P=0.001). Conclusion The proportion of using additional oxytocin and blood loss increased in CM in singleton pregnant women with intramural myomas,but the risk of severe postpartum hemorrhage (PPH) did not increase.

Key words: different types of uterine myomas, cesarean myomectomy (CM), operation features, delivery outcomes