Case Reports in Obstetrics and Gynecology (Jan 2014)

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

  • Lavinia Domenici,
  • Violante Di Donato,
  • Maria Luisa Gasparri,
  • Francesca Lecce,
  • Jlenia Caccetta,
  • Pierluigi Benedetti Panici

DOI
https://doi.org/10.1155/2014/154347
Journal volume & issue
Vol. 2014

Abstract

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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.