Huge Fibroid in Pregnancy: A Case Presentation

Abstract

Uterine fibroid, widely known as leiomyoma, is one of the most common benign tumours of the female reproductive system. It is not uncommon for pregnancies to be complicated by uterine fibroids. Most commonly, the first line of large uterine fibroids management in pregnancy is conservative, with myomectomy counselling after delivery if necessary. In this paper, we present a case of a very high-risk pregnancy, that was managed by delivery via caesarean section at 34 weeks of gestation, which was performed for a patient, with an 18 centimetres (cm) fibroid, first diagnosed during pregnancy. Interventional radiology involvement was critical in this case for minimizing the final blood loss and surgical complications. Bilateral internal iliac artery balloons were used. Maternal and foetal risks, the timing of delivery, and the options for the management of fibroids in pregnancy will be discussed.

Keywords: antenatal scan; caesarean section; gestation age; huge fibroid; radiology interventional; uterine fibroid in pregnancy.

Figure 1. Transvaginal scan: CRL and foetus seen, one day after the initial presentation.

Figure 2. Transvaginal scan: a 187*134mm uterine fibroid was seen.

Figure 3. Anterior view of the MRI scan (abdomen and pelvis). The fibroid is seen.

Figure 4. Bilateral internal iliac artery balloons.