DOI: https://doi.org/10.36347/sasjs.2026.v12i10.014

Pages: 883-889

Background: In Cameroon, abdominal myomectomy remains the standard approach for large multifibroid uteri, and haemorrhage is its main complication. We aimed to identify factors associated with severe haemorrhage during abdominal myomectomy. Methods: We conducted a retrospective case–control study at the Yaoundé Teaching Hospital for Endoscopic Surgery and Human Reproduction (January 2016 – March 2018) and the Yaoundé Gynaeco-Obstetric and Paediatric Hospital (January 2013 – December 2017). Cases had a total blood loss ≥ 1000 mL (intraoperative loss plus 48-hour drain output) and/or perioperative transfusion; controls (two per case) had neither. Variables significant on bivariate analysis were entered into a binary logistic regression model. Results: Of 366 recorded procedures, 225 files were analysed (75 cases, 150 controls). Independent factors were previous laparotomy (adjusted odds ratio [aOR] 5.56; 95% confidence interval [CI] 2.28–13.54; p < 0.001), uterine size ≥ 20 weeks (aOR 5.14; 95% CI 1.92–13.76; p = 0.001), dominant fibroid ≥ 10 cm (aOR 3.27; 95% CI 1.33–7.94; p = 0.009) and body mass index ≥ 30 kg/m² (aOR 2.62; 95% CI 1.03–6.65; p = 0.042). Conclusion: The risk of severe haemorrhage can be anticipated at the first consultation: previous abdominal scar, large uterus, large dominant fibroid and obesity. These criteria should guide blood reservation, preoperative preparation and referral to a tertiary centre.