Laparoscopic myomectomy during pregnancy

Objective To describe a unique case of laparoscopic myomectomy during pregnancy. Setting A university-affiliated maternity hospital. Subject A 27-year-old primigravida presenting with acute abdominal pain at 15 weeks of gestation. A diagnosis of torsion of a subserous myoma was made following failure of conservative treatment. Intervention On laparoscopy, a 7-cm subserous pedunculated myoma was demonstrated. Laparoscopic myomectomy was successfully accomplished. Results No intra- or postoperative complications were recorded. The woman delivered vaginally a healthy baby at 39 weeks' gestation. Conclusions Laparoscopic myomectomy during pregnancy is feasible. This procedure cannot be generally recommended since data concerning the safety of laparoscopic operation in general and myomectomy in particular, are limited. The patients should be carefully selected, and the operation should be performed by an experienced surgeon to guarantee a favourable outcome.

[1]  D. Chaffin,et al.  Fetal Response to Carbon Dioxide Pneumoperitoneum in the Pregnant Ewe , 1995, Obstetrics and gynecology.

[2]  F. Howard,et al.  Laparoscopic adnexal surgery during pregnancy. , 1994, The Journal of the American Association of Gynecologic Laparoscopists.

[3]  C. Exacoustos,et al.  Ultrasound diagnosis of uterine myomas and complications in pregnancy , 1993, Obstetrics and gynecology.

[4]  M. Levardon,et al.  Benefit of operative laparoscopy for ovarian tumors suspected of benignity. , 1992, Journal of laparoendoscopic surgery.

[5]  T. Dahms,et al.  Hypercarbia during carbon dioxide pneumoperitoneum. , 1992, American journal of surgery.

[6]  R. W. Seed,et al.  Case report of laparoscopic cholecystectomy in the third trimester of pregnancy. , 1991, American journal of obstetrics and gynecology.

[7]  V. Sivanesaratnam,et al.  Uterine leiomyomata in pregnancy , 1991, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[8]  E. Shalev,et al.  Laparoscopic relief of adnexal torsion in early pregnancy. Case reports , 1990, British journal of obstetrics and gynaecology.

[9]  K. Glavind,et al.  Uterine Myoma in Pregnancy , 1990, Acta obstetricia et gynecologica Scandinavica.

[10]  D. Grimes,et al.  Surgical Management of Leiomyomata During Pregnancy , 1989, Obstetrics and gynecology.

[11]  W. Droegemueller,et al.  Complications of Uterine Leiomyomas in Pregnancy , 1989, Obstetrics and gynecology.

[12]  D. Muram,et al.  Myomas of the uterus in pregnancy: ultrasonographic follow-up. , 1980, American journal of obstetrics and gynecology.