Giant uterine leiomyoma in a pregnant woman – case study and review of literature

Kinga Kadelska, Małgorzata Sokołowska, Sebastian Kwiatkowski, Joanna Lebdowicz-Knul, Wioletta Mikołajek-Bedner, Yousef Al-Heib, Andrzej Torbé


The case of successful pregnancy outcome in a 39-year-old nulligravida with an enormous leiomyoma is presented. At 16th week of gestation patient began to complain of dyspnoea and abdominal pain. Due to rapid growth, high vascularization, worsening pain, respiratory symptoms and limited conditions for foetal development, surgery was taken. Repeat sonography was performed at the 20th week and normal fetal development consistent with a 2nd trimester pregnancy was observed. Singular fibroids 1–5 cm in diameter were visualized and no tumor growth was noted when compared with subsequent ultrasound studies. At the 39th week, the patient was referred to the hospital for preparations towards elective cesarean section due to a breech presentation. During the planned cesarean section, numerous subscapular fibroids were observed which were left without intervention. The patient delivered a live female neonate, in a good condition, weighting 3280 g. There were no complications during the surgery and the postpartum period.


uterine leiomyoma; pregnancy complications

Full Text:



Cooper NP, Okolo S. Fibroids in pregnancy – common but poorly understood. Obstet Gynecol Surv 2005;60(2):132-8.

Practice Committee of American Society for Reproductive Medicine in collaboration with Society of Reproductive Surgeons. Myomas and reproductive function. Fertil Steril 2008;90(5 Suppl):S125-30.

Cook H, Ezzati M, Segars JH, McCarthy K. The impact of uterine leiomyomas on reproductive outcomes. Minerva Gynecol 2010;62(3):225-36.

Verkauf BS. Myomectomy for fertile enhancement and preservation. Fertil Steril 1992;58(1):1-15.

Alam NA, Olpin S, Leigh IM. Fumarate hydratase mutations and predispositions to cutaneous leiomyomas, uterine leiomyomas and renal cancer. Br J Dermatol 2005;153(1):11-7.

Parazzini F, La Vecchia C, Negri E, Cecchetti G, Fedele L. Epidemiologic characteristic of women with uterine fibroids: a case-control study. Obstet Gynecol 1988;72(6):853-7.

Ciarmela P, Islam MS, Reis FM, Gray PC, Bloise E, Petraglia F, et al. Growth factors and myometrium: biological effects in uterine fibroid and possible clinical implications. Hum Reprod Update 2011;17(6):772-90.

Pritts EA, Parker WH, Olive DL. Fibroids and infertility: an updated systematic review of the evidence. Fertil Steril 2009;91(4):1215-23.

Bulletti C, de Ziegler D, Levi Setti P, Cicinelli E, Polli V, Stefanetti M. Myomas, pregnancy outcome, and in vitro fertilization. Ann NY Acad Sci 2004;1034:84-92.

Bengalia L, Cardellicchio L, Filippi F, Paffoni A, Vercellini P, Somigliana E, et al. The rapid growth of fibroids during early pregnancy. PLoS One 2014;9(1):e85933.

Seracchioli R, Manuzzi L, Vianello F, Gualerzi B, Savelli L, Paradisi R, et al. Obstetric and delivery outcome of pregnancies achieved after laparoscopic myomectomy. Fertil Steril 2006;86(1):159-65.

Sinclair D, Gaither K, Mason TC. Fertility outcomes following myomectomy in an urban hospital setting. J Natl Med Assoc 2005;97(10):1346-8.

De Vivo A, Mancuso A, Giacobbe A, Savasta LM, De Dominici R, Dugo N, et al. Uterine myomas during pregnancy: a longitudinal sonographic study. Ultrasound Obstet Gynecol 2011;37(3):361-5.

Bińkowska M, Dębska M, Dębski R. Olbrzymi mięśniak macicy u ciężarnej – opis przypadku. Ginekol Pol 2009;80(12):946-8.

Klatsky PC, Tran ND, Caughey AB, Fujimoto VY. Fibroids and reproductive outcomes: a systematic literature review from conception to delivery. Am J Obstet Gynecol 2008;198(4):357-66.

Lozza V, Pieralli A, Corioni S, Longinotti M, Penna C. Multiple laparotomic myomectomy during pregnancy: a case report. Arch Gynecol Obstet 2011;284(3):613-6.

Lolis DE, Kalantaridou S, Makrydimas G, Sotiriadis A, Navrozoglou I, Zikopoulos K, et al. Successful myomectomy during pregnancy. Hum Reprod 2003;18(8):1699-702.

Domenici L, Di Donato V, Gasparri ML, Lecce F, Caccetta J, Panici PB. Laparotomic myomectomy in the 16th week of pregnancy: a case report. Case Rep Obstet Gynecol 2014;2014:154347.

De Carolis S, Fatigante G, Ferrazzani S, Trivellini C, De Santis L, Mancuso S, et al. Uterine myomectomy in pregnant women. Fetal Diagn Ther 2001;16(2):116-9.

Danzer E, Holzgreve W, Batukan C, Miny P, Tercanli S, Hoesli I. Myomectomy during the first trimester associated with fetal limb anomalies and hydrocephalus in a twin pregnancy. Prenat Diagn 2011;21(10):848-51.

Kasum M. Hemoperitoneum caused by a bleeding myoma in pregnancy. Acta Clin Croat 2010;49(2):197-200.

Isabu P, Eigbefoh J, Okogbo F, Okunsanya S, Eifediyi R. Myomectomy during second trimester pregnancy: a case report. Niger Postgrad Med J 2010;17(4):324-6.

Kobayashi F, Kondoh E, Hamanishi J, Kawamura Y, Tatsumi K, Konishi I. Pyomayoma during pregnancy: a case report and review of the literature. J Obstet Gynaecol Res 2013;39(1):383-9.

Wong L, Ching TW, Kok TL, Koon TH. Spontaneous hemoperitoneum from an uterine leiomyoma in pregnancy. Acta Obstet Gynecol Scand 2005;84(12):1208-9.

Exacoustòs C, Rosati P. Ultrasound diagnosis of uterine myoma and complications in pregnancy. Obstet Gynecol 1993;82(1):97-101.

Strobelt N, Ghidini A, Cavallone M, Pensabene I, Ceruti P, Vergani P. Natural history of uterine leiomyomas in pregnancy. J Ultrasound Med 1994;13(5):399-401.


Copyright (c) 2020 Andrzej Torbe, Yousef Al-Heib, Wioletta Mikołajek-Bedner, Joanna Lebdowicz-Knul, Sebastian Kwiatkowski, Kinga Kadelska, Małgorzata Sokołowska

License URL: