Wassan Nori and co-authors published a review article entitled “Reducing Intraoperative Bleeding in Fibroid Surgery and Cesarean Myomectomy: From Traditional to Innovative Approach–A Review” in Clinical and Experimental Obstetrics & Gynecology (CEOG), Volume 52, Issue 11. (https://www.imrpress.com/journal/CEOG/52/11/10.31083/CEOG43924)

Zeena Helmi Department of Obstetrics and Gynecology, College of Medicine, Mustansiriyah University, 10052 Baghdad, Iraq

We are honored to invite one of the co-authors, Dr. Zeena Helmi, to provide an interpretation of the article. Dr. Helmi is an Assistant Professor at Mustansiriya University, College of Medicine, Baghdad, Iraq. She holds a PhD in Obstetrics and Gynecology and has extensive academic and clinical experience in women’s health.

Her academic and research interests focus on infertility, reproductive medicine, and gynecological disorders. She has contributed to several scientific research projects and has published in international peer-reviewed journals. Dr. Helmi combines clinical practice with academic teaching and research, and she is actively involved in medical education and scientific publication.

Author's Interpretation

This review aims to give clinicians practical insights to improve surgical outcomes and patient safety.

Uterine fibroids represent the most common benign tumor of the uterus in women of reproductive age. Despite the rising incidence of fibroids during pregnancy, there is no consensus on the optimal strategy to minimize bleeding during a cesarean section (C-section). We aim to provide an up-to-date, evidence-based overview to guide clinical decision-making and to highlight a knowledge gap for future research.

In Methods:

Three electronic databases were searched using the keywords "fibroids", “intraoperative bleeding", “cesarean myomectomy", and "pregnancy", following the inclusion and exclusion criteria. Four major categories were identified for reducing intraoperative bleeding: medical, surgical, innovative, and experimental. For each technique, data were collected and synthesized into tables.

Findings in Brief:

Medical techniques were effective, although they had side effects, and their efficacy can be enhanced when used in combination. Surgical techniques proved effective, especially when medical techniques failed, especially in complicated cases. Emerging modalities show promising efficacy with minimal impact on fertility but still need validation.

In Conclusions:

A personalized, multidisciplinary approach is needed to effectively control intraoperative bleeding. Current practice should shift toward risk stratification using predictive tools to estimate bleeding preoperatively. Surgical teams should develop personalized bleeding-control strategies intraoperatively with pharmacological agents. Future research should examine how to integrate artificial intelligence (AI) while preserving fertility and patient safety. 

Original Article:

Reducing Intraoperative Bleeding in Fibroid Surgery and Cesarean Myomectomy: From Traditional to Innovative Approach - A Review: https://www.imrpress.com/journal/CEOG/52/11/10.31083/CEOG43924

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