Myomectomy of Giant Myoma during the First Trimester of Pregnancy: A case report
Wenny Yaury1*, Nugraha U. Pelupessy1**, Putra Rimba1***

1 Department of Obstetrics and Gynecology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Email: Wyaury[at]gmail.com*

Abstract

Background:
About 0.1-10.7% of leiomyoma cases affect pregnant women. Conservative management is preferred because myomectomy during pregnancy is still controversial due to the risk of hemorrhage, pregnancy injury, and pregnancy loss.

Clinical Case:
A 32 years old nulliparous woman with a gestational age of 14+5/7 weeks had chief complaints of worsening swollen abdomen. An ultrasonographic examination revealed an ovarian tumor. Intraoperatively, we found subserosal leiomyoma. Myomectomy was performed using a uterine tourniquet (Foley catheter no.18) and a double-circle stitch technique. The pregnancy was continued.

Result:
A sizeable subserosal leiomyoma (35x30x13 cm) with a weight of 14 kg was successfully removed in a 90 minutes procedure with an estimated 400 cc of blood loss. The histopathological result showed a hyaline uterine leiomyoma. The infant was delivered with a caesarean section at term.

Conclusion: We can perform a safe myomectomy during the first trimester of pregnancy.

Keywords: Pregnancy, Giant myoma, myomectomy

Topic: Maternal, neonatal, and child health