# Review on Symptomatic pedunculated leiomyomas in pregnancy with special consideration of an example case

## TL;DR

This paper reviews cases of large fibroids during pregnancy and shows that surgical removal can be safe and effective.

## Contribution

The paper provides a case example and literature review to support myomectomy as a safe option for large pedunculated fibroids in pregnancy.

## Key findings

- Myomectomy is safe for pedunculated fibroids during pregnancy.
- Laparotomy is recommended for fibroids larger than 10 cm.
- Surgical removal does not preclude vaginal birth in such cases.

## Abstract

Symptomatic pedunculated leiomyomas in pregnancy; review of the literature with special consideration of an example case.

Retrospective narrative review with an example case.

Systematic evaluation of 37 reports.

A 36-year-old Caucasian primigravida was referred symptomatic at 16 + 0 weeks due to a 13,5 cm myoma causing pain, constipation, urine retention and dysesthesias. Our patient underwent myomectomy at 17 + 0 weeks. One pedunculated leiomyoma was successfully removed.

Myomectomy can be performed and is safe for pedunculated fibroids in pregnancy. Depending on the clinical scenario, surgical removal may be indicated. Based on the size of the fibroids and expected adhesions, a laparotomy is a safe option and is not a contraindication for vaginal birth in the case of pedunculated fibroids. Myomas larger than 10 cm should be removed by laparotomy.