Laparotomic Myomectomy in the 16th Week of Pregnancy: A Case Report

Abstract

Myomectomy is rarely performed during an ongoing pregnancy because of fear of miscarriage and the risk of an uncontrolled haemorrhage necessitating a hysterectomy. In cases where myomectomy is undertaken, most are performed at the time of cesarean section or with a laparoscopic approach. We report a case of a successful laparotomic myomectomy in the 16th week of pregnancy. A 35-year-old primigravida was admitted to our department with acute abdominal pain and hydronephrosis (serum creatinine 1.6 mg/dL). Imaging revealed a large implant myoma compressing the bladder, ureters, rectus, and gestational chamber and causing hydronephrosis. Laparotomic myomectomy was successfully performed and pregnancy continued uneventfully until the 38th week when a cesarean section was performed. Surgical management of myomas during pregnancy is worth evaluating in well-selected and highly symptomatic cases.

Antenatal Myomectomy: Is It Safe?

“…However, in the face of increasing of evidence, the obstetrician could be reassured that second trimester myomectomy is considered a safe option in selected patients and under the hand of an experienced surgeon (10). Therefore, with better outcomes as were reported, it could further strengthen the safety of the procedure and feasibility of new management approach for antenatal fibroids.…”

Miomectomía en gestante de 14 semanas: a propósito de un caso

“…La miomectomía conlleva riesgos de hemorragia y aborto por lo que solamente se reserva para casos puntuales que no respondan al manejo expectante (11). La recomendación actual y la experiencia indican que se debe realizar en el segundo trimestre de gestación aunque hay casos reportados en el primer trimestre.…”

Myomectomy in pregnancy: feasibility and safety

“…9 Myomectomy was done with reconstruction of uterine wall. Pregnancy continued and delivered a healthy baby at 38 weeks of pregnancy weighing 3250 gms.…”