When conception comes with a huge price: a case report of giant uterine leiomyoma co-existing with pregnancy

Abstract

Introduction: The management of huge intra-abdominal mass in pregnancy, a rare condition, involves careful evaluation and occasional surgical intervention. Low and middle-income countries are specifically faced with late and often-time, life-threatening presentations of this condition. The managing team should be equipped with the relevant clinical skills to care for this category of patients despite the limited resources at their disposal.

Case report:  We report a case of a 38-year-old primigravida who presented with a history of progressive abdominal swelling and weight loss of 6 years, as well as severe respiratory distress of 4 months. She had a background history of primary infertility for 14 years and menstrual irregularity of 6 years. The patient had a positive serum pregnancy test and radiological findings in keeping with a giant intra-abdominal mass and a viable pregnancy. An assessment of huge intra-abdominal mass co-existing with pregnancy was made. She eventually had laparotomy with removal of the mass and preservation of the pregnancy after initial resuscitation. The histology of the mass revealed a uterine leiomyoma. The Pregnancy progressed to term and was delivered of a live male neonate via a caesarean section.

Conclusion: Huge uterine fibroid in pregnancy poses a great challenge because of the associated risks and complications during surgical intervention. However, early detection and prompt decision-making processes reduce or prevent morbidity and mortality from the condition.