A Multilobulated Intramural Fibroid in Pregnancy: A Clinical Case Report

Leiomyoma is the most common benign tumor of the female reproductive tract. It is prevalent among women in the age group 30 to 50 years. Other than placental estrogens and progesterone, a range of endocrine and paracrine factors have their impact on fibroid blood supply, growth rate, and risk of degeneration during the gestational and puerperal periods. The current case report is about a 30-year-old primigravida with pregnancy and a large fibroid presenting with complications such as malpresentation and pressure symptoms, ending up in a cesarean section at 36 weeks delivering a live baby with a birth weight of 2.5 kgs and a large fibroid weighing 6.4 kg. During the pregnancy, there was adequate fetal development, without major maternal complications. There were four crucial issues: tailored pregnancy surveillance, the decision of time and route of delivery, postpartum hemorrhage management, the decision to perform an interval myomectomy, and the management of decreasing blood loss perioperatively.