The purpose of this video is to demonstrate surgical management of a large symptomatic fibroid in the 2nd trimester of pregnancy.
This patient is a 26 year old G1P0 who presented to a tertiary care centre at 18 weeks and 3 days gestational age with severe abdominal pain, not controlled with intravenous and oral narcotics. She was otherwise healthy and incidentally was diagnosed with a fibroid during her dating ultrasound.
An MRI of her abdomen and pelvis delineated this to be a pedunculated fundal uterine fibroid, measuring 19.4 by 13.2 by 16.2cm, retroplacental in location. Ultimately, she was consented for a laparoscopic myomectomy, with mini-laparotomy and morcellation.
Post-operatively, this patient’s pregnancy progressed well and was uncomplicated. She underwent an uncomplicated spontaneous vaginal delivery at 40 weeks gestational age.
University of Toronto