Myomectomy for a Large Submucosal Fibroid at the Time of Caesarean Section

Submucosal uterine fibroids are usually associated with infertility and miscarriage. Hence, term pregnancies with large submucosal fibroids are rare in clinical practice. The management of fibroids during pregnancy remains controversial. We, herein, describe a case of natural conception, complicated with a massive submucosal fibroid in a 29-year primigravida. The pregnancy was uneventful with satisfactory fetal growth on serial ultrasound scans until the 41st week of gestation. At the time of caesarean section, we performed myomectomy successfully after bilateral uterine artery ligation. There was no blood transfused perioperatively. The patient achieved a satisfactory recovery and was discharged on day-4 after surgery. This case indicates that myomectomy during caesarean section may be a safe and feasible intervention in carefully selected cases of submucosal fibroids. Key Words: Myomectomy, Submucosal fibroid, Pregnancy, Caesarean section.