Uterine rupture in pregnancy after myomectomy is about 0.3%, higher when the cavity was entered: systematic review
Groffils C, Paelinck L, van Wessel S, et al. Obstet Gynecol Int. 2026. PMID 42893144 (opens in a new tab) doi:10.1155/ogi/6048559 (opens in a new tab)
- Study
- Systematic review (MEDLINE, Embase, Web of Science, Cochrane Library; two reviewers) of 31 studies published between April 2013 and October 2023, covering 13,381 pregnancies after a myomectomy; the cavity-entry comparison rests on 380 women.
- Finding
- Uterine rupture during pregnancy or labour occurred in 0.30% (40/13,381; 95% CI 0.21-0.41), about 3 in every 1,000 pregnancies. It was more frequent when the cavity had been entered at the myomectomy (3/44, 6.82%) than when it had not (4/336, 1.19%), OR 6.07, p = 0.04. The type of myomectomy (laparoscopic, open or robotic) did not significantly influence the risk, the studies gave insufficient data to estimate the risk in a trial of labour, and no other consistent risk factor was found.
Supports current practice moderate evidence
Confirms the rupture figure used in counselling, supports recording cavity entry in the operation note for the obstetric team, and gives no reason to steer patients away from laparoscopic or robotic myomectomy.
- What it means
- For a woman planning a pregnancy after a myomectomy, the womb tearing is rare: about 3 in every 1,000 pregnancies, with no difference between keyhole, robotic and open operations.
Conflicts of interest: Funding not stated in the abstract.
Reviewed by Mr Jan, .