Abstract
Author(s): Marta Kochanowicz, JarosÅaw KaroÅ, Tahar Ben Rhaiem
The paper presents a 37-year-old nullipara admitted as an emergency to the Obstetric and Gynecologic Ward of the Independent Public Health Care Facility in Kedzierzyn-Kozle in Poland for diagnosis and possible treatment of a tumor occupying the pelvis minor and abdominal cavity, the fundus of which reached the navel level. A transvaginal US examination revealed the presence of live intrauterine pregnancy; fetal CRL: 1.47 cm, i.e. 7 weeks and 6 days. Pelvic MRI demonstrated diffuse tumorous lesions within the abdominal cavity, hypogastric region and pelvis, probably corresponding to leiomyomas. One of them was located in a typical site within the uterine body, more to the right side. The other lesion was pedunculated and remained in little contact with the uterus. It showed features of decomposition and occupied a considerable area of the abdominal intraperitoneal space. Due to the size of these fibroids, their location and obstetric history, the patient was deemed eligible for abdominal myomectomy. The procedure was performed in the typical fashion. The patient was discharged on day 9 after the procedure with preserved live pregnancy. The course of pregnancy was uncomplicated until week 25. Then, premature contractile activity of the uterus was observed, and slight pain at the site of the scar was reported. The patient was hospitalized until week 37 of gestation. At week 37, pregnancy was concluded with a cesarean section. The patient delivered a boy weighing 2,730 g with the body length of 52 cm; Apgar scale 6.