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Gynaecologia et perinatologia : journal for gynaecology, perinatology, reproductive medicine and ultrasonic diagnostics, Vol. 18 No. 2, 2009.

Case report

SUCCESSFUL MYOMECTOMY DURING PREGNANCY: A CASE REPORT

Miro Kasum ; Klinika za ženske bolesti i porode KBC-a Medicinskog fakulteta Sveučilišta u Zagrebu, Petrova 13, Zagreb
Slavko Orešković ; Klinika za ženske bolesti i porode KBC-a Medicinskog fakulteta Sveučilišta u Zagrebu, Petrova 13, Zagreb
Josip Đelmiš ; Klinika za ženske bolesti i porode KBC-a Medicinskog fakulteta Sveučilišta u Zagrebu, Petrova 13, Zagreb

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Abstract

A case of 42 years old woman at 15 weeks of gestation with lower abdominal pain and hemodinamical instability with signs of acute abdomen due to intraabdominal bleeding is presented. There was a history of gynaecological examination several hours earlier, and the complaints started following palpation. Soon after admission the patient underwent immediatelly to exploratory laparatomy which revealed massive hemoperitoneum. A subserosal uterine leiomyoma of 8,5 cm in size was found in the fundal area, with an actively bleeding ruptured vessel on its dome. Myomectomy was successfully performed and 1,5 liter of blood and blood clots were evacuated from the peritoneal cavity. The operation continued by dissection of the upper part of abdominal wall to explore the upper abdomen. No additional sources of bleeding were found. The histology report showed sections of interlacing bundles of smooth muscles with areas of bleeding and hyaline and necrotic degeneration. The subsequent antenatal period was uneventful. The early amniocenthesis was performed at 19 week of gestation and the finding was a normal male kariotype. At 25 weeks of gestation cervical cerclage was performed due to cervical incompetence. The woman went into spontaneous labour at 38+4 weeks of gestation and deliveried vaginally a healthy male baby weighing 3,4 kg with Apgar score 10,10. This paper supports other studies and case series that have demonstrated the safety of myomectomy during pregnancy in selected patients and especially in the situations of vital danger.

Keywords

leiomyoma; pregnancy; myomectomy

Hrčak ID:

65721

URI

https://hrcak.srce.hr/65721

Publication date:

1.6.2009.

Article data in other languages: croatian

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