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Review
. 2025 Jun;311(6):1543-1552.
doi: 10.1007/s00404-024-07840-4. Epub 2024 Nov 27.

Review on Symptomatic pedunculated leiomyomas in pregnancy with special consideration of an example case

Jonas Bubmann  1 , Carl Mathis Wild  1   2 , Christian Dannecker  1   2 , Manuela Franitza  1 , Bernadette Eser  1 , Marina C Seefried  1 , Thomas Kroencke  3 , Philipp Voisard  1 , Udo Jeschke  4 , Fabian Garrido  1
Affiliations
Review

Review on Symptomatic pedunculated leiomyomas in pregnancy with special consideration of an example case

Jonas Bubmann et al. Arch Gynecol Obstet. 2025 Jun.

Abstract

Objectives/hypothesis: Symptomatic pedunculated leiomyomas in pregnancy; review of the literature with special consideration of an example case.

Study design: Retrospective narrative review with an example case.

Methods: Systematic evaluation of 37 reports.

Example case: A 36-year-old Caucasian primigravida was referred symptomatic at 16 + 0 weeks due to a 13,5 cm myoma causing pain, constipation, urine retention and dysesthesias. Our patient underwent myomectomy at 17 + 0 weeks. One pedunculated leiomyoma was successfully removed.

Conclusion: Myomectomy can be performed and is safe for pedunculated fibroids in pregnancy. Depending on the clinical scenario, surgical removal may be indicated. Based on the size of the fibroids and expected adhesions, a laparotomy is a safe option and is not a contraindication for vaginal birth in the case of pedunculated fibroids. Myomas larger than 10 cm should be removed by laparotomy.

Keywords: Fibroids; Laparoscopy; Laparotomy; Myomectomy; Pedunculated myoma; Pregnancy.

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Conflict of interest statement

Declarations. Conflict of interest: U.J. received travel money from pfm. C.D. is funded by Roche, AstraZeneca, TEVA, Mentor, and MCI Healthcare. All other authors declare no conflict of interest. Informed consent and Ethical approval: Informed consent for research and publication purposes was obtained from the patient mentioned in the study before collecting data.

Figures

Fig. 1
Fig. 1
Preoperative MRI. T2-weighted images in the sagittal and coronal plane depicts a pedunculated sub serosal Leiomyoma (arrowhead) and the fetus (asterisk). The vascular pedicle visualized by worm-like signal-free vessels (arrowhead) suggests an attachment side of the leiomyoma to the posterior wall of the uterus. Degenerative changes (white spots) are seen within the leiomyoma
Fig. 2
Fig. 2
Stump of the pedicle
Fig. 3
Fig. 3
Myoma
Fig. 4
Fig. 4
Overview of the review process
See this image and copyright information in PMC

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