Huge Fibroid in Pregnancy: A Case Presentation

TL;DR

This paper presents a rare case of a large uterine fibroid during pregnancy and its management through caesarean section and interventional radiology.

Contribution

The case highlights the use of interventional radiology techniques, such as bilateral internal iliac artery balloons, in managing high-risk pregnancies with large fibroids.

Findings

A 34-week caesarean section was performed for a patient with an 18 cm fibroid diagnosed during pregnancy.

Interventional radiology minimized blood loss and surgical complications in this high-risk case.

The case emphasizes the importance of multidisciplinary management in fibroid-related pregnancies.

Abstract

Uterine fibroid, widely known as leiomyoma, is one of the most common benign tumours of the female reproductive system. It is not uncommon for pregnancies to be complicated by uterine fibroids. Most commonly, the first line of large uterine fibroids management in pregnancy is conservative, with myomectomy counselling after delivery if necessary. In this paper, we present a case of a very high-risk pregnancy, that was managed by delivery via caesarean section at 34 weeks of gestation, which was performed for a patient, with an 18 centimetres (cm) fibroid, first diagnosed during pregnancy. Interventional radiology involvement was critical in this case for minimizing the final blood loss and surgical complications. Bilateral internal iliac artery balloons were used. Maternal and foetal risks, the timing of delivery, and the options for the management of fibroids in pregnancy will be discussed.

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