Myomectomy in the second trimester of pregnancy: case report

Uterine leiomyomas are characterized as a benign disease and are observed in 2 to 3% of all normal pregnancies. Out of these, about 10% may present complications during pregnancy. We present a case of a pregnant patient sought emergency obstetric care at the 17th week, complaining of severe pain, presenting with painful abdominal palpation and sudden positive decompression. Ultrasonography revealed a myoma nodule measuring 9.1 x 7.7 cm; the patient was hospitalized and medicated, being also submitted to laparotomy and myomectomy due to worsening of her condition. Prenatal care revealed no further abnormalities, with resolution of gestation at 39 weeks. The newborn weighed 3,315 g, with Apgar scores of 9 and 10. In such cases, clinical treatment should always be attempted and surgery should be considered only in selected cases, mainly in the impossibility of conservative treatment or when the patient's clinical features require immediate intervention. In this case, myomectomy was effective against maternal-fetal obstetric complications.