Large myomatous uterus resulting in complete obstruction of the inferior vena cava during pregnancy

incidence is during the third or fourth decade of life. Leiomyomas occur in 2 – 4% of pregnancies, and their incidence in pregnancy may be increasing as women delay childbearing 2,3 . In addition, routine use of ultrasound during pregnancy has increased the detection of leiomyomas 3 . Leiomyomas in pregnancy may be associated with a variety of pregnancy complications, including miscarriage, preterm rupture of the membranes, preterm labour, placental abruption, painful degeneration, postpartum haemorrhage, fetal malpresentation, fetal growth restriction and the need for caesarean delivery, with or without hysterectomy 2 . Complications may be related to the size and location of the leiomyomas 4 . We describe the clinical course of a pregnant woman with a very large myomatous uterus resulting in complete obstruction of the inferior vena cava early in the second trimester of pregnancy. No previous report of complete obstruction of the inferior vena cava from a myoma during pregnancy was found during a Medline search of the English literature from 1966 to the present by using the keywords ‘leiomyoma’, ‘thrombosis’, ‘inferior vena cava’, ‘fibroid’, and ‘pregnancy’.