Massive Subserosal Myomectomy at 19 Weeks of Gestation with Successful Pregnancy Outcome: A Case Report and Literature Review

Antenatal myomectomy is rarely performed as it carries high risk of intractable haemorrhage and hysterectomy. Majority of myomectomies are performed at the time of caesarean section or after pregnancy. We report a case of successful abdominal myomectomy (laparotomy) in 26 years old primigravida at 19 weeks of gestation who presented with acute abdominal pain, pelvic pressure symptoms and difficulty in breathing due to huge abdominal mass. Imaging revealed a large multiple sub- serous and intramural myomas extended to xiphoid sternum compressing the diaphragm. Laparotomy myomectomy was performed successfully. The subsequent antenatal ultrasound showed short cervix of 0.5 cm. Patient was on follow up with cervical length assessment and was on Injectable Hydroxyprogesterone Caproate . Anti natal period was uneventful and she delivered vaginally at 37 weeks of gestation with no complications. This report supports the safety of myomectomy during pregnancy in selected scenarios.