Huge symptomatic uterine fibroids coexisting with pregnancy in a primigravida – successful inevitable Caesarean myomectomy in a private hospital.

Ikoro C1,2, Oriji PC2*, Njoku C2, Afolabi SA2, Mbah KM2, Tekenah ES2, Okoro C1, Onomrefeduvwu E1
1Department of Obstetrics and Gynaecology, Metrixmed Clinic Limited, Biogbolo, Yenagoa, Bayelsa State, Nigeria.
2Department of Obstetrics and Gynaecology, Federal Medical Centre, Yenagoa, Yenagoa, Bayelsa State, Nigeria.
*Correspondence: Dr. Oriji, Peter Chibuzor; +234 706 423 3209;

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Background: Caesarean myomectomy is traditionally discouraged, and very controversial because of the significantly increased risk of haemorrhage and postoperative morbidity of myomectomy from the increased vascularity of the gravid uterus. However, some reports have shown that myomectomy during Caesarean delivery can be safe.
Case presentation: Successful urgent inevitable Caesarean myomectomy of huge symptomatic myomas in a primigravida at 33 weeks and 6 days’ gestation after she had been previously booked for scheduled Caesarean delivery at 34 weeks’ gestation for severe respiratory distress/embarrassment due to huge uterine fibroid co-existing with pregnancy.
Discussion: Though Caesarean myomectomy ought to and should still be handled with caution, there is increasing evidence of its safety especially in well-selected cases and in experienced hands. It is heartening that elective Caesarean myomectomy can be performed safely in resource poor environment like ours where the need is more using low technology techniques.
Conclusion: Removal of symptomatic uterine fibroids during Caesarean delivery should be embarked on where the necessary skill is available especially where it can interfere with uterine closure at surgery, cause uterine atony and predispose to post-partum haemorrhage. It also decreases the complications associated with uterine fibroids in subsequent pregnancies.

Keywords: Caesarean myomectomy, Huge myoma, Post-partum haemorrhage

Cite this article: Ikoro C, Oriji PC, Njoku C, Afolabi SA, Mbah KM, Tekenah ES, et al. Huge symptomatic uterine fibroids coexisting with pregnancy in a primigravida – successful inevitable Caesarean myomectomy in a private hospital. Yen Med J. 2019;1(1):66-72.


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