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| Successful Laparotomic myomectomy during pregnancy: a case report
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Jebryl el Haoudani, Yassine Belhaj, N. Edith Ngalande, FZ fdili alaoui ,Sofia jayi, My abdelilah melhouf et Hekmat Chaara
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Abstract:
Although leiomyomas usually remain asymptomatic during pregnancy, they may complicate its course. The management of uterine fibroids during pregnancy is usually expectant and surgical removal is generally delayed until after delivery. In this case study, we present a large, symptomatic uterine fibroid diagnosed during pregnancy which was successfully managed by an antepartum laparotomic myomectomy. Case presentation: A 30-year-old primigravida woman presented in the obstetric-gynecology emergency room with, amenorrhea of 18-week duration and severe epigastric discomfort which increased in intensity in the week before her consultation. The fundal height was greater than gestational age. A sonographic diagnosis of 3 uterine fibroids in pregnancy was made. Laparotomy revealed 3 uterine fibroids co-existing with an intrauterine pregnancy; the largest was a pedunculated subserosal fibroid on the anterior part of the fundus measuring 17x9cm and the second was also a pedunculated subserosal fibroid at the posterior aspect of the fundus measuring 5x4cm the third was an intramural fibroid measuring 6x4cm on the anterior aspect of the uterus. Myomectomy was successfully performed on the two pedunculated myomas without opening of the uterine cavity. The subsequent antenatal period was uneventful with a spontaneous vaginal delivery of a male baby at 38 weeks. The last intra mural fibroid was later excised at 8 months post-partum. Conclusion: This report supports other studies and case series that have demonstrated the safety of myomectomy during pregnancy in selected circumstances.
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