Myomectomy in Pregnancy- A Safe Mode of Therapy. Case Discussion

Abstract

Uterine leiomyoma (Fibroids) that occurs in pregnant women, on occasion, undergoes degeneration and causes sharp pain. Analgesics and a number of home remedies, including local soothing measures, are the recommended form of treatment. Surgery is generally avoided. However, for those women, the pain is persistent, and surgical removal is the only option.
We reported a Case of a pregnant woman who presented at thirteen weeks’ gestation with abdominal pain due to a degenerative fibroid. She was initially managed with analgesics and some home measures. The pain persisted, and thus, resorted to surgical management at the fifteenth week of gestation. Three leiomyomas were removed. All showed degenerative changes. The blood loss was 100 ml. This is the third case we performed, all with satisfactory outcomes. The pregnancy is progressing well now at thirty weeks of gestation. We also analyze literature reviews involving a significant number of articles and cases. All these revealed a similar pattern in the presentation, surgical management, and histology reports. Complications were minimal. No maternal death was reported. Pregnancy outcome was satisfactory.

Therefore, myomectomy in pregnancy should become a routine form of management in cases that present with the complication of pain, not relieved by analgesics and other measures.