Unavoidable Caesarean Myomectomy Due to Multiple Anterior Uterine Fibroids: A Case Report

Abstract

Background: Caesarean myomectomy is still a controversial issue in current obstetric practice due to the fear of uncontrollable haemorrhage. However, it may become very necessary occasionally with increased prevalence of fibroids among our pregnant mothers. Case Report: We report a case of Mrs UC, a 30-year-old primigravid woman who booked for antenatal care at 16 weeks gestational age following a 3-year history of infertility. The pregnancy was complicated with abdominal pain from red degeneration of uterine fibroid and was managed with pentazocine in the 2nd trimester. She presented in labour at 39 weeks and 4 days but labour was prolonged for 8 hours, having adequate contractions without any significant improvement in both descent and cervical dilatation. She subsequently had an emergency caesarean myomectomy with an outcome of a live female neonate that weighed 3.1kg with good Apgar scores and 2 pieces of uterine myoma that weighed 1.1kg. The post-operative and puerperal periods were uneventful. Conclusion: Caesarean myomectomy, a controversial obstetric procedure, can be indicated when the location and size of the fibroid mass makes caesarean delivery only very challenging and difficult.