A case of successful delivery in a patient with large uterine leiomyoma

Abstract

Uterine leiomyoma occurs in women over 35 years of age in 25–30% and in pregnant women in about 3–12%. However, in 10% of pregnant women, it turns out to be an accidental finding and is detected by ultrasound examination in the first trimester of pregnancy Approximately 10–30% of pregnant women with uterine leiomyoma have complications during pregnancy, childbirth and the postpartum period. The article demonstrates a case of successful delivery in a patient with uterine myoma at full-term pregnancy with preservation of reproductive function in a maternity hospital of the 3^rd level. In the period of 38–39 weeks, the patient was hospitalized in the maternity hospital. By the decision of the council, the pregnant woman was prepared for a planned operative delivery. A lower median laparotomy was performed for adequate access. Performed caesarean section in the lower segment according to Defler. During the operation, a live, full-term girl weighing 3600 g and height 53 cm, 7/8 points on the Apgar scale was extracted. On the left, along the anterior surface of the uterus in the bottom area, a subserous myomatous node on a pedicle is determined, measuring 300*220*150 mm. Blunt and sharp dissection of adhesions was performed, followed by removal of a myomatous node weighing more than 1 kg. The postoperative period was uneventful. The patient was discharged on the 5^th day. In our clinical case, a successful myomectomy was performed during a planned caesarean section. This type of surgery can be considered a safe option in carefully selected cases and a cost-effective method. However, this method should be performed by experienced surgeons who are skilled in the technique and take into account the size and location of the myomatous node.