Multiple laparotomic myomectomy during pregnancy: a case report

Abstract

The presence of uterine myomas during pregnancy is considered a risk factor for gestation and delivery. In literature, myomas are related to spontaneous abortion, bleeding, PPROM, preterm delivery, placenta previa, placental abruption, fetal malpresentations, mechanical dystocia and high incidence of cesarean section. Laparotomic myomectomy done during pregnancy is indicated when symptoms related to uterine myomas, as acute pelvic pain or gastroenteric or urinary symptoms, persist despite the pharmacological therapy. The purpose of this study is to show a successful surgical management of uterine myomas at 15.5 weeks of pregnancy, which allowed the continuation of gestation and a delivery without major complications.

Uterine Fibroid Torsion during Pregnancy: A Case of Laparotomic Myomectomy at 18 Weeks’ Gestation with Systematic Review of the Literature

“…Overall, 63 [3–6, 10–67] articles were incorporated for further assessment. The study selection process is shown in Figure 2.…”

“…Conservative management with anti-inflammatory therapy is considered a gold standard, and surgery is generally avoided during pregnancy because of the risks of hysterectomy secondary to severe hemorrhage, pregnancy injury, and pregnancy loss [3]. The main conditions that induce inevitably the surgical procedure are the torsion of pedunculated fibroids or rare cases of necrosis, resultant inflammatory peritoneal reaction, and, finally, if symptoms persist after 72 hours of pharmacological therapy [4–7].…”

“…There are many controversies in performing myomectomy during cesarean section because of the risk of hemorrhage [3]. Nevertheless, the majority of indication arises before labor and delivery due to acute symptoms leading to a discussion regarding the need for intervention during pregnancy.…”

Fibrome prævia : une cause rare d’occlusion intestinale aiguë en cours de grossesse

“…La plupart ont é té faites au second trimestre (avant 22 SA), avec des issues de grossesse favorables. Les indications principales é taient la né crobiose aseptique et la torsion d'un fibrome pé diculé [6,7].…”

Antenatal Myomectomy: Is It Safe?

“…Available literatures are mainly restricted to case reports and retrospective studies. As such, a surgical approach is usually reserved for cases of intractable abdominal pain or persistent gastroenteric and urinary symptoms despite pharmacological treatment (4)(5)(6). Majority of the reported myomectomies were performed in second trimester for intractable pelvic pain and had excellent results.…”