Uterine rupture and placenta accreta spectrum following laparoscopic myomectomy in Japan: A message from obstetricians to gynecologic laparoscopists

Abstract

Laparoscopic myomectomy (LSM) is a procedure often requested by patients because of its minimal invasiveness. This procedure has, therefore, been widely performed in recent years. However, there is a need for more reports from the obstetric field to determine the effects of this procedure on subsequent pregnancies. In this regard, we searched Japanese medical literature databases for articles on Japanese cases of uterine rupture, placenta increta, or placenta percreta in pregnancy following myomectomy. This review article aims to analyze the retrieved data to clarify the issues involved and to provide useful feedback to gynecologists by sharing information with them on such issues. in pregnancy following LSM, comprising 2 full term cases (8.0%), 18 preterm cases (72.0%), and 5 abortion cases (at 7, 10, 16, 19, and 21 gestational weeks) (20.0%). There was no distinct difference between the frequencies of uterine rupture following LTM and LSM in relation to the abortion period or the preterm period. Cases of uterine rupture following LSM included 3 cases who had undergone subserous myomectomy in which electrocauterization alone was used for resection and hemostasis. In 4 cases, the submucosal myoma had been enucleated, with exposure of the endometrium. intraabdominal rupture