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Case Reports in Obstetrics and Gynecology
Volume 2014 (2014), Article ID 154347, 5 pages
http://dx.doi.org/10.1155/2014/154347
Case Report

Laparotomic Myomectomy in the 16th Week of Pregnancy: A Case Report

Department of Obstetrics, Gynecology and Urologic Sciences, “Sapienza” University, Viale Del Policlinico 155, 00155 Rome, Italy

Received 16 December 2013; Accepted 18 January 2014; Published 4 March 2014

Academic Editors: M. Furuhashi, M. K. Hoffman, M. A. Osmanagaoglu, and P. Schuetze

Copyright © 2014 Lavinia Domenici et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Myomectomy is rarely performed during an ongoing pregnancy because of fear of miscarriage and the risk of an uncontrolled haemorrhage necessitating a hysterectomy. In cases where myomectomy is undertaken, most are performed at the time of cesarean section or with a laparoscopic approach. We report a case of a successful laparotomic myomectomy in the 16th week of pregnancy. A 35-year-old primigravida was admitted to our department with acute abdominal pain and hydronephrosis (serum creatinine 1.6 mg/dL). Imaging revealed a large implant myoma compressing the bladder, ureters, rectus, and gestational chamber and causing hydronephrosis. Laparotomic myomectomy was successfully performed and pregnancy continued uneventfully until the 38th week when a cesarean section was performed. Surgical management of myomas during pregnancy is worth evaluating in well-selected and highly symptomatic cases.