Preoperative magnetic resonance imaging and antepartum myomectomy of a giant pedunculated leiomyoma.

Abstract

Antepartum myomectomy is reserved for severe pain and prevention of fetal complications. Magnetic resonance imaging has been useful in nonpregnant women for preoperative management and patient counseling. A primigravida was admitted at 12 weeks of gestation in severe acute abdominal pain with a large abdominal mass, confirmed by magnetic resonance imaging to be a pedunculated 30x27x19-cm uterine leiomyoma. An uncomplicated abdominal myomectomy was performed, incorporating a flat cup vacuum device to mobilize the mass without disturbing the gravid uterus. The patient later had an uncomplicated term vaginal delivery and healthy newborn. Magnetic resonance imaging and a flat cup vacuum device were helpful in preoperative planning and performing an uncomplicated abdominal myomectomy during pregnancy, respectively.