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Introduction of Intracapsular Rotary-cut Procedures IRCP: A Modified Hysteromyomectomy Procedures Facilitating Fertility Preservation
Published on: January 17, 2019
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Myoma praevia and pregnancy
Yousra Krimou1, Sanae Erraghay1, Ahmed Guennoun1
1Department of Obstetrics and Gynecology I, University Hospital Center Hassan II, Fez, Morocco.
The Pan African Medical Journal
|November 7, 2019
Summary
Pregnancy with large uterine fibroids (leiomyomas) is increasingly common. This case highlights a 37-year-old woman with a 25cm fibroid requiring cesarean delivery and hysterectomy, with a normal recovery.
Area of Science:
- Obstetrics and Gynecology
- Reproductive Medicine
- Surgical Gynecology
Background:
- Increasing maternal age is associated with a higher incidence of uterine leiomyomas (fibroids) during pregnancy.
- Uterine fibroids can complicate fertility, pregnancy progression, labor, and the postpartum period.
- The management of large fibroids discovered late in pregnancy presents unique clinical challenges.
Observation:
- A 37-year-old pregnant patient at 37 weeks gestation was diagnosed with a large (16cm) anterior isthmic uterine leiomyoma via ultrasound.
- Intraoperative findings revealed a significantly larger interstitial isthmic uterine myoma measuring 25cm.
- The patient underwent cesarean delivery followed by a corporeal hysterectomy.
Findings:
- Cesarean delivery was successfully performed for a term pregnancy complicated by a massive uterine leiomyoma.
- A large interstitial isthmic uterine myoma measuring 25cm necessitated a corporeal hysterectomy.
- The patient experienced an uncomplicated postoperative and puerperium course following the procedure.
Implications:
- This case underscores the importance of vigilant monitoring and management of large uterine fibroids in pregnant patients.
- Timely surgical intervention, including hysterectomy when necessary, can lead to favorable outcomes even with substantial fibroid burden.
- Advances in obstetric and gynecologic surgery allow for successful management of complex cases involving large fibroids during pregnancy.
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