Successful Second Trimester Myomectomy in a Critically Ill Patient

Uterine leiomyomas (myomas) poses antenatal, intrapartum and postnatal risks, including pregnancy loss, preterm delivery, antepartum and postpartum haemorrhage, abnormal placental implantation, fetal malpresentation, mechanical dystocia and need for caesarean section. Though traditionally contraindicated due to their risk of pregnancy loss and massive haemorrhage, antenatal myomectomies have been shown to be beneficial in selected cases in more recent studies. We present a case of a patient who underwent a successful open subserosal myomectomy at 24 weeks gestation for worsening pelvic pain and subacute bowel obstruction. Following a turbulent post-operative phase and admission to the critical care unit, the pregnancy continued without further complications. At 38 weeks gestation, the patient underwent an uncomplicated elective caesarean section.