Successful Outcome of Pregnancy of a Sub-fertile Woman with Multiple Fibroids and Placenta Praevia and Accreta

Abstract

Fibroids, the commonest benign pelvic tumor, have a common association with subfertility and increasing maternal age. Placenta praevia and fibroid (if submucous) has an association with placenta accreta. Here we report the case of an elderly primigravida with history of prolong subfertility, admitted with 37 weeks pregnancy with multiple fibroids and central placenta praevia with focal increta. Even with all these complicating factors, with the advent of better uterotonic drugs, conservative management could be considered successfully now-a-days. Introduction:Fibroids are the commonest of all pelvic tumours, being present in 20 percent of women in reproductive age group. They are frequently multiple and more common in nulliparous and relatively infertile women 1,2 . Most fibroids are asymptomatic during pregnancy and are diagnosed on routine ultrasound examination 2 . Approximately 10% of pregnant patients with fibroids have complications related to or caused by the fibroids. These can be: first trimester loss, compression effect from myomas on the mother as well as on the fetus, pain (red degeneration), premature labour, premature rupture of the membranes, malpresentation, placenta praevia, retained placenta, postpartum hemorrhage and puerperal sepsis 3,4 .