SUCCESSFUL CONCEPTION AND FIRST PREGNANCY IN A 28-YEAR-OLD WOMAN WITH CERVICAL UTERINE MYOMA AND TOTAL PLACENTA PREVIA: A CASE REPORT
DOI:
https://doi.org/10.61841/te0naj48Keywords:
Placenta previa, primigravida, Cervical Uterine MyomaAbstract
Background: Placenta previa is a major pregnancy complication associated with life-threatening hemorrhage. Cervical Uterine Myomas, benign smooth muscle tumors, increase the risk of placenta previa by two to three times, contributing to adverse pregnancy outcomes such as infection, urinary retention, preterm labor, and bleeding. Understanding the interaction between Cervical Uterine Myomas and placenta previa is crucial for optimizing care in high-risk pregnancies and improving maternal and fetal outcomes.
Case Description: A 28-year-old primigravida (G1P0A0) patient was diagnosed with a breech presentation, Cervical Uterine Myoma, and total placenta previa at Klungkung Regional Hospital. The patient had a regular menstrual cycle and no history of comorbid conditions. The patient's management includes hospitalization with strict bed rest, followed by a scheduled elective cesarean section (CS). Fluid therapy will be administered using Ringer's lactate, and preoperative prophylactic antibiotics will be provided.
Discussion: Cervical Uterine Myoma, particularly cervical myomas, can significantly impact pregnancy outcomes, with a prevalence of 1.6% to 10.7%. These fibroids, particularly large ones, increase the risk of placenta previa, a condition where the placenta partially or completely covers the cervix. The combination presents significant risks for both the obstetrician and the patient, including urinary retention, myoma degeneration, preterm labor, obstructed labor, and postpartum hemorrhage. Careful surgical planning and management strategies are crucial.
Conclusion: A 28-year-old primigravida with breech presentation, Cervical Uterine Myoma, and total placenta previa was admitted after three days of abdominal pain and scheduled for an elective cesarean section at 36 weeks. The cesarean successfully delivered a healthy male infant, and a 10 x 10 cm cervical myoma was identified without complications. Postoperatively, the patient had a normal recovery with well-healing surgical wounds and was discharged in stable condition with appropriate medications.
References
Khirasaria, D. M., & Nayak, T. C. (2017). A study of complications in cases of placenta previa. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 6(12), 5503. https://doi.org/10.18203/2320-1770.ijrcog20175269
Cresswell, J. A., Ronsmans, C., Calvert, C., & Filippi, V. (2013). Prevalence of placenta praevia by world region: a systematic review and meta-analysis. Tropical medicine & international health : TM & IH, 18(6), 712–724. https://doi.org/10.1111/tmi.12100
Barik, A., Singh, V., Choudhary, A., & Yadav, P. (2021). Central Placenta Previa With Coexisting Central Cervical Fibroid in Pregnancy: An Obstetrician's Nightmare. Cureus, 13(6), e15910. https://doi.org/10.7759/cureus.15910
Vergani, P., Locatelli, A., Ghidini, A., Andreani, M., Sala, F., & Pezzullo, J. C. (2007). Large uterine leiomyomata and risk of cesarean delivery. Obstetrics and gynecology, 109(2 Pt 1), 410–414. https://doi.org/10.1097/01.AOG.0000250470.78700.f0
Klatsky, P. C., Tran, N. D., Caughey, A. B., & Fujimoto, V. Y. (2008). Fibroids and reproductive outcomes: a systematic literature review from conception to delivery. American journal of obstetrics and gynecology, 198(4), 357–366. https://doi.org/10.1016/j.ajog.2007.12.039
Straub, H. L., Chohan, L., & Kilpatrick, C. C. (2010). Cervical and prolapsed submucosal leiomyomas complicating pregnancy. Obstetrical & gynecological survey, 65(9), 583–590. https://doi.org/10.1097/OGX.0b013e3181fc5602
Milazzo, G. N., Catalano, A., Badia, V., Mallozzi, M., & Caserta, D. (2017). Myoma and myomectomy: Poor evidence concern in pregnancy. The journal of obstetrics and gynaecology research, 43(12), 1789–1804. https://doi.org/10.1111/jog.13437
Kim, M. L., Hong, K., Kim, S., Lee, M. J., Shim, S. S., Hur, Y. M., & Shin, J. S. (2020). Twin pregnancies with uterine fibroids are not at increased risk for obstetric complications: single center cohort study. BMC pregnancy and childbirth, 20(1), 222. https://doi.org/10.1186/s12884-020-02908-w
Abam, D. S., & Kasso, T. (2017). Uterine Fibroids and Pregnancy: A Review of the Challenges. In Obstetrics. InTech. https://doi.org/10.5772/intechopen.71761
Lee, H. J., Norwitz, E. R., & Shaw, J. (2010). Contemporary management of fibroids in pregnancy. Reviews in obstetrics & gynecology, 3(1), 20–27.
Laughlin, S. K., Baird, D. D., Savitz, D. A., Herring, A. H., & Hartmann, K. E. (2009). Prevalence of uterine leiomyomas in the first trimester of pregnancy: an ultrasound-screening study. Obstetrics and gynecology, 113(3), 630–635. https://doi.org/10.1097/AOG.0b013e318197bbaf
Zhao, R., Wang, X., Zou, L., Li, G., Chen, Y., Li, C., & Zhang, W. (2017). Adverse obstetric outcomes in pregnant women with uterine fibroids in China: A multicenter survey involving 112,403 deliveries. PloS one, 12(11), e0187821. https://doi.org/10.1371/journal.pone.0187821
Jenabi, E., & Fereidooni, B. (2019). The uterine leiomyoma and placenta previa: a meta-analysis. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 32(7), 1200–1204. https://doi.org/10.1080/14767058.2017.1400003
Tîrnovanu, M. C., Lozneanu, L., Tîrnovanu, Ş. D., Tîrnovanu, V. G., Onofriescu, M., Ungureanu, C., Toma, B. F., & Cojocaru, E. (2022). Uterine Fibroids and Pregnancy: A Review of the Challenges from a Romanian Tertiary Level Institution. Healthcare (Basel, Switzerland), 10(5), 855. https://doi.org/10.3390/healthcare10050855
Barik, A., & Ray, A. (2020). A Rare Case of Pregnancy Complicated by Uterine Prolapse and Cervical Fibroid. Cureus, 12(7), e9026. https://doi.org/10.7759/cureus.9026
Fawcus, S., & Moodley, J. (2013). Postpartum haemorrhage associated with caesarean section and caesarean hysterectomy. Best practice & research. Clinical obstetrics & gynaecology, 27(2), 233–249. https://doi.org/10.1016/j.bpobgyn.2012.08.018
Guo, X. C., & Segars, J. H. (2012). The impact and management of fibroids for fertility: an evidence-based approach. Obstetrics and gynecology clinics of North America, 39(4), 521–533. https://doi.org/10.1016/j.ogc.2012.09.005
Kathpalia, S. K., Arora, D., Vasudeva, S., & Singh, S. (2016). Myomectomy at cesarean section: A safe option. Medical journal, Armed Forces India, 72(Suppl 1), S161–S163. https://doi.org/10.1016/j.mjafi.2016.03.006
Keriakos, R., & Maher, M. (2013). Management of Cervical Fibroid during the Reproductive Period. Case reports in obstetrics and gynecology, 2013, 984030. https://doi.org/10.1155/2013/984030
Carranza-Mamane, B., Havelock, J., Hemmings, R., REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY COMMITTEE, & SPECIAL CONTRIBUTOR (2015). The management of uterine fibroids in women with otherwise unexplained infertility. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC, 37(3), 277–285. https://doi.org/10.1016/S1701-2163(15)30318-2
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Ida Bagus Agung Brahmananda Krisna Putra, I Komang Juni Arthawan, AA Gde Marvy Khrisna Pranamartha, I Gede Sudiarta, Putu Ayu Novianitri, I kadek Pramarta, I Nym Gde Dwipa Mahardikha, Suryantha Adisastra (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Licensing
Ninety Nine Publication publishes articles under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This licensing allows for any use of the work, provided the original author(s) and source are credited, thereby facilitating the free exchange and use of research for the advancement of knowledge.
Detailed Licensing Terms
Attribution (BY): Users must give appropriate credit, provide a link to the license, and indicate if changes were made. Users may do so in any reasonable manner, but not in any way that suggests the licensor endorses them or their use.
No Additional Restrictions: Users may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
