Asian Research Journal of Gynaecology and Obstetrics

Massive Subserosal Myomectomy at 19 Weeks of Gestation with Successful Pregnancy Outcome: A Case Report and Literature Review

Shadya Al Saeghi *

Department of Obstetrics and Gynaecology, Nizwa Hospital, Oman.

Rahma Al Ghabshi

Infertility and Reproductive Endocrine, Khoula Hospital, Oman.

Maryam Al Shabibi

Infertility and Reproductive Endocrine, Royal Hospital, Oman.

Hansa Dhar

Department of Obstetrics and Gynaecology, Nizwa Hospital, Oman.

Fatma Al Shuraiqi

Department of Radiology, Nizwa Hospital, Oman.

*Author to whom correspondence should be addressed.

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Abstract

Antenatal myomectomy  is rarely performed as it  carries high risk of intractable haemorrhage and hysterectomy. Majority of myomectomies are performed at the time of caesarean section or after pregnancy. We report a case of successful abdominal myomectomy (laparotomy) in 26 years old primigravida at 19 weeks of gestation who presented with acute abdominal pain, pelvic pressure symptoms and difficulty in breathing due to huge abdominal mass. Imaging revealed a large multiple sub- serous and intramural myomas extended to xiphoid sternum compressing the diaphragm. Laparotomy myomectomy was performed successfully. The subsequent antenatal ultrasound showed short cervix of 0.5 cm. Patient was on follow up with cervical length assessment and was on Injectable Hydroxyprogesterone Caproate . Anti natal period  was uneventful and she delivered vaginally at 37 weeks of gestation with no complications. This report supports the safety of myomectomy during pregnancy in selected scenarios.

Keywords: Pregnancy, leiomyoma, myomectomy, live birth, 2nd trimester, miscarriage

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