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Successful maternal and perinatal outcomes in a term pregnancy with giant abdominopelvic leiomyomatosis
Jai Bhagwan Sharma1, Alka Kriplani1, Monica Gupta1
1Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.
A 30-year-old second gravida with history of laparoscopic myomectomy and one previous caesarean section was admitted at 31 weeks and 2 days period of gestation (POG) with a diagnosis of diffuse abdominopelvic leiomyomatosis and moderate anaemia. After correction of anaemia with intravenous iron and erythropoietin, laparotomy was performed at 37 weeks POG. A healthy female baby weighing 2.9 kg was delivered by classical caesarean section followed by hysterectomy in view of multiple fibroid uterus with uncontrolled bleeding. Debulking surgery was performed, and multiple large intraperitoneal leiomyomata with encasing blood vessels were removed. There was another 15×15 cm leiomyoma arising from the diaphragm which was excised. She received 4 units of packed red blood cells and fresh frozen plasma intraoperatively. The postoperative course was uneventful, both mother and baby were healthy and discharged 7 days after surgery.
A 30-year-old second gravida with history of laparoscopic myomectomy and one previous caesarean section was admitted at 31 weeks and 2 days period of gestation (POG) with a diagnosis of diffuse abdominopelvic leiomyomatosis and moderate anaemia. After correction of anaemia with intravenous iron and erythropoietin, laparotomy was performed at 37 weeks POG. A healthy female baby weighing 2.9 kg was delivered by classical caesarean section followed by hysterectomy in view of multiple fibroid uterus with uncontrolled bleeding. Debulking surgery was performed, and multiple large intraperitoneal leiomyomata with encasing blood vessels were removed. There was another 15×15 cm leiomyoma arising from the diaphragm which was excised. She received 4 units of packed red blood cells and fresh frozen plasma intraoperatively. The postoperative course was uneventful, both mother and baby were healthy and discharged 7 days after surgery.
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