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Vaginal Myomectomy for Semipedunculated Cervical Myoma during Pregnancy

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      Abstract

      Objective Cases of prolapsed myoma in which pregnancy was carried to full term or near term after vaginal myomectomy are very rare. Previously, only two such cases have been reported. In addition, both those patients had a pedunculated leiomyoma, which could be treated by twisting or clamping. Here, we report a case of a patient who was able to carry her pregnancy to term despite vaginal myomectomy for semipedunculated myoma at 13 weeks of pregnancy.

      Study Design This study is a case presentation.

      Results The myoma nucleus was removed by making an incision on the surface of the mass. Systemic and transvaginal antibiotics were prescribed after the surgery. Uterine contractions, short cervix, or cervical funneling was not observed in the remaining duration of pregnancy.

      Conclusion While performing myomectomy during pregnancy, removal of the myoma nucleus is safer than twisting. In addition, postoperative administration of local or systemic antibiotic agents does not adversely affect pregnancy.

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      Most cited references 4

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      Cervical and prolapsed submucosal leiomyomas complicating pregnancy.

      Cervical and prolapsed submucosal leiomyomas are rarely seen in pregnancy. Depending on the size threshold used to diagnose a leiomyoma, the prevalence of uterine leiomyomas in pregnancy is approximately 3% to 10%. The prevalence of clinically evident cervical leiomyomas in pregnancy is less than 1%. Contrary to prior thought, the majority of uterine leiomyomas in pregnancy do not usually lead to complications. Indications for surgical intervention in pregnancy for cervical leiomyomas include bleeding, infection, degeneration, pain, and urinary stasis. Preoperative imaging with ultrasound and magnetic resonance imaging may help to delineate the location and nature (e.g., pedunculated) of the cervical leiomyoma when clinical examination is inconclusive. We reviewed the current literature in regard to cervical leiomyomas in pregnancy and summarize the major findings. After completing this CME activity, readers should be better able to evaluate the prevalence and natural history of uterine and cervical leiomyomas in pregnancy, assess indications for surgical intervention in pregnant patients, manage surgical complications, and select imaging modalities that may determine their origin.
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        Vaginal Myomectomy in Pregnancy A Report of Two Cases

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          Vaginal removal of prolapsed pedunculated submucosal myoma during pregnancy

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            Author and article information

            Affiliations
            [1 ]Department of Obstetrics & Gynecology, HIRAKA General Hospital, Yokote City, Akita, Japan
            Author notes
            Address for correspondence Dr. Mikitaka Obara, MD Department of Obstetrics & Gynecology, HIRAKA General Hospital 3-1 Yatsuguchi, Maego, Yokote city, Akita, Postcode 013-8610Japan ob6329@ 123456gmail.com
            Journal
            AJP Rep
            AJP Rep
            10.1055/s-00000169
            AJP Reports
            Thieme Medical Publishers (333 Seventh Avenue, New York, NY 10001, USA. )
            2157-6998
            2157-7005
            12 March 2014
            May 2014
            : 4
            : 1
            : 37-40
            4078159 10.1055/s-0034-1370352 130031
            © Thieme Medical Publishers
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