KSMFM factsheet on obstetric complications after myomectomy or adenomyomectomy: uterine rupture and placenta accreta spectrum

Over the past 20 years, as the number of women of reproductive age in Korea diagnosed with uterine leiomyoma and adenomyosis prior to pregnancy has increased, fertility-preserving uterine surgeries such as myomectomy and adenomyomectomy have also increased. Although these surgeries can preserve fertility, they can cause serious obstetric complications, such as uterine rupture and placenta accreta spectrum (PAS). The incidence of uterine rupture after myomectomy is reported to be 0.5-1.52%, whereas the incidence after adenomyomectomy is considerably higher, ranging from 3.2 to 12.5%. A key clinical characteristic is that rupture can occur before labor regardless of gestational age, making clinical prediction difficult. Furthermore, myomectomy and adenomyomectomy carry a high risk of PAS, which can lead to severe maternal and neonatal morbidity. Therefore, women of childbearing age should receive sufficient counseling before deciding on surgery and undergo thorough prenatal care throughout pregnancy.