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. 2011 Nov 5:5:545.
doi: 10.1186/1752-1947-5-545.

Laparoscopic myomectomy of a subserous pedunculated fibroid at 14 weeks of pregnancy: a case report

Mario Ardovino  1 , Italo Ardovino, Maria Antonietta Castaldi, Antonietta Monteverde, Nicola Colacurci, Luigi Cobellis
Affiliations

Laparoscopic myomectomy of a subserous pedunculated fibroid at 14 weeks of pregnancy: a case report

Mario Ardovino et al. J Med Case Rep. .

Abstract

Introduction: Uterine leiomyomas are seen in 1.6% to 4% of pregnancies. With the increasing age of obstetric patients, more cases are being encountered during pregnancy.

Case presentation: We report the case of a 31-year-old Caucasian woman with acute recurrent abdominal pain due to a subserous fundic myoma, measuring 48 × 52 × 63 mm, with an implantation base of 22 × 18 mm, which was successfully treated by laparoscopy at 14 weeks of pregnancy. At a gestational age of week 40, the patient spontaneously delivered a healthy 3216 g girl baby.

Conclusion: As far as we know, this is the first reported case of laparoscopic myomectomy this early during a pregnancy. Our experience together with an analysis of cases reported in the literature suggests that myomectomy during pregnancy may be considered safe, but only in the hands of experienced laparoscopic surgeons. There are a few reports in the literature about laparoscopic myomectomy during the first half of pregnancy that demonstrate its feasibility in selected cases. Some technical tools could improve the procedure with a minimum of risk for the ongoing pregnancy.

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Figures

Figure 1
Figure 1
Subserous myoma, with its implantation base localized in the fundic right lateral region and a consistent adherence to the anterior abdominal wall.
Figure 2
Figure 2
The ischemic myoma at the beginning of the enucleation by bipolar electrosurgical device (PKS Plasmaspatula, Gyrus Medical Inc, Minneapolis, MN).
Figure 3
Figure 3
Myoma enucleation.
Figure 4
Figure 4
The uterus at the end of the intervention with the strangled and ischemic minimum residual tissue.
See this image and copyright information in PMC

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