Pregnancy-preserving myomectomy: preliminary report on a new surgical technique

Abstract

Uterine myomas are found in 0.3-2.6% of pregnant women. In one case out of ten they cause complications. Treatment is primarily conservative but in cases of failure, surgery cannot be avoided. We present a case of a pregnant woman with myomas. Because of failure of conservative management and severe abdominal pain, we performed a myomectomy at 18 weeks' gestation with preservation of the pregnancy. We describe a modified surgical technique whereby interrupted sutures are first placed around the myoma for haemostasis. We achieved good pregnancy outcome by caesarean section carried out near term. Incidence, presentation, and challenges associated with the management of myomas during pregnancy are briefly discussed.