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Revista chilena de obstetricia y ginecología

versión On-line ISSN 0717-7526


MOSLEMI Y, Ima et al. Miomectomía en gestante de 14 semanas: a propósito de un caso. Rev. chil. obstet. ginecol. [online]. 2016, vol.81, n.2, pp.130-134. ISSN 0717-7526.

Background: The prevalence of uterine fibroids in pregnancy is 0.3 to 2.6%, 10% of which complicate during pregnancy. The surgical management of fibroids in pregnant women is reserved for complicated cases. Case report: The patient is 36 years old, first pregnancy, consulting at 11 weeks of gestation with bloating, edema in the lower extremities and mild vaginal bleeding. Physical examination and ultrasound evidence a 23 cm diameter fibroid and gestational sac with live embryo in the left upper abdominal quadrant. In subsequent tests the patient worsens clinically due to fibroid growth, presenting intense abdominal pain, increased edema in both lower extremities. Imaging studies report pyelocalyceal bilateral ectasia and compression of iliac veins. Given these findings and symptoms a myomectomy is performed without incidents at 14 weeks of gestation. Postoperative and subsequent tests are normal and caesarean section is preformed at 37 weeks of gestation. Discussion: myomectomy in pregnancy carries risks of bleeding and abortion. It is reserved for cases that do not respond to expectant management. The current recommendation and experience indicate that it has to be performed in the second trimester. Conclusion: Myomectomy in pregnancy is a technique that should be considered in selected cases and has few complications.

Palabras clave : Uterine fibroid; myomectomy; pregnancy.

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