Abstract
An: 2023, Nr.1, Articol Nr. 2
Title:
UTERINE FIBROIDS AND PREGNANCY: HOW DO THEY AFFECT EACH OTHER? OUTCOME OF A VERY RARE CASE OF POLYFIBROMATOSIS DURING PREGNANCY
Authors:
Ana Haliciu - University of Medicine and Pharmacy “Gr. T. Popa” Iaşi, Romania, Faculty of Medicine, Department of Morphofunctional Sciences I; Obstetrics and Gynecology Hospital “Elena Doamna” Iaşi, Romania
Andreea Luduşanu, Angela Tecuceanu, R. Tepordei, Simona Vicoleanu Partene, A. Nedelcu - University of Medicine and Pharmacy “Gr. T. Popa” Iaşi, Romania, Faculty of Medicine, Department of Morphofunctional Sciences I
R.L. Zanfirescu - University of Medicine and Pharmacy “Gr. T. Popa” Iaşi, Romania, Faculty of Medicine, Student
UTERINE FIBROIDS AND PREGNANCY: HOW DO THEY AFFECT EACH OTHER? OUTCOME OF A VERY RARE CASE OF POLYFIBROMATOSIS DURING PREGANCY (Abstract): Pregnancy has a variable and unpredictable effect on fibroid growth. Due to the fact that, usually fibroids give no symptoms at all to the patient, only 7 of 10 women had severe abdominal pain requiring hospitalization. Very rarely does the presence of a single fibroid during pregnancy lead to an unfavorable outcome. The outcome and evolution of most women with both pregnancies and fibroids were no different regarding the incidence of risk factors such as: preterm delivery, placenta previa or postpartum hemorrhage. Fetal injury attributed to mechanical compression by fibroids is common as well. This is a case of a 37-year-old woman admitted for evaluation and therapeutic conduct for vaginal bleeding and severe abdominal pain. She was being known to be 12 weeks pregnant, presenting also a uterine tumor in her medical history. She was conscious with good vital signs and hemodynamically stable. Upon inspection of the abdomen, its volume is observed 3 cm above the navel, with a polycyclic contour and increased consistency. Local clinical examination shows normal-appearing and intact vaginal mucosa and significant vaginal bleeding. Pelvic ultrasonography shows a uterus with an irregular outline and numerous hyperechoic images that oriented the presumptive diagnosis of uterine polyfibromatosis. Despite the hemostatic treatment administered, the vaginal bleeding persists and the blood pressure values decrease (SBP: 80 mmHg; DBP: 50 mmHg) so the patient is rushed in the OR. Subtotal hysterectomy was needed, accompanied by right adnexectomy and left salpingectomy, as well as Douglas drainage. The extracted fragments are sent for anatomical-pathological examination. This case is a spectacular example showing the controversial involvement of uterine fibroids in miscarriage and preterm birth that is also cited in the literature. Thereupon, the prognosis of this pregnancy would have been reserved due to the large size of the fibroids.
Key words: UTERINE FIBROIDS, PREGNANCY, VAGINAL BLEEDING, ABDOMINAL PAIN, MISCARRIAGE
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