Facts, Views & Vision
in ObGyn

Journal of the European Society for Gynaecological Endoscopy

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Current opinion on large-scale prospective myomectomy databases toward evidence-based preconception and antenatal counselling utilising a standardised myomectomy operation note

S.M. Strong1, A.A. McDougall2, A.M. Abdelmohsen3, A. Maku4, A. Dehnel5, R. Mallick6, F. Odejinmi1

1 Whipps Cross University Hospital, Whipps Cross Road, London, E11 1NR, UK
2 Homerton University Hospital, Homerton Row, London, E9 6SR, UK
3 William Harvey Hospital, Kennington Road, Ashford, Kent TN24 0LZ, UK
4 Medway Maritime Hospital, Windmill Road, Gillingham, Kent ME7 5NY, UK
5 Maidstone Tunbridge Wells NHS Trust, Hermitage Lane, Maidstone, Kent, ME16 9QQ, UK
6 Brighton and Sussex University Hospitals NHS Trust, Kemptown Brighton, BN2 1ES, UK

Keywords:

Leiomyoma, Minimal Access Surgery, Uterine Rupture, Antenatal, Fibroids


Published online: Mar 28 2024

https://doi.org/10.52054/FVVO.16.4.006

Abstract

Background: No large-scale databases exist of pregnancy outcomes and rate of uterine rupture for women after myomectomy, resulting in inconsistent antenatal counselling and decision-making regarding mode and timing of delivery. Standardising information collected at myomectomy may facilitate data collection, informing prenatal/ antenatal counselling.

Objectives: To determine clinician opinions regarding standardisation of myomectomy operation notes to allow comprehensive data input into a prospective database of pregnancy outcomes, toward an evidence-based approach to decision making regarding timing and mode of delivery in subsequent pregnancies.

Materials and Methods: A google forms survey was emailed to all consultant (attending-level) obstetricians and gynaecologists across 25 hospitals in London, Kent, Surrey, and Sussex (UK) between March and May 2022. To enhance response rates, two further email reminders were sent alongside in-person reminders from selected local unit representatives.

Main outcome measures: Senior clinician opinion for characteristics necessary to collect at time of surgery to develop a widescale database of post myomectomy pregnancy outcomes.

Results: 209/475 (44%) responses received; 95% (198/209) agreed with standardising operation notes. Criteria selected for inclusion included cavity breach (98%, 194/198), location (98%, 194/198), number of fibroids removed (93%, 185/198) and number of uterine incisions (96%, 190/198).

Conclusions: Gynaecologists support standardising myomectomy operation notes to inform the development of prospective large-scale databases of pregnancy outcomes after myomectomy.

What is new? Acquisition of clinician opinions on the development and content of a standardised myomectomy operation note to aid the development of a pregnancy-outcome database for women after myomectomy.