Abstract

BRANEZ GARCIA, Cristhian Alexander; ESPINOZA QUINTEROS, Jacqueline; GUTIERREZ RICALDI, Victor  and  CAMACHO CLAROS, Claudia. MIOMECTOMIA DURANTE EL EMBARAZO. Gac Med Bol [online]. 2007, vol.30, n.2, pp.47-53. ISSN 1012-2966.

This is the presentation of the case of a 36-year-old, multigest, with a background of three Caesareans, admitted in our service with a 19-week, complicated gestation and with a giant cervical uterine myomatosis, which caused obstruction of lower urinary tracts, and therefore, with a high risk of a renal complication. Consequently, an aggressive surgical treatment is performed: myomectomy during pregnancy. On the fourth day of the postoperative period, a new surgical operation is carried out due to bleeding of the myoma bed (complicated with a hypovolemic shock), and it is possible to restrain the hemorrhage; thus, the patient keeps pregnancy under strict control, first with intensive therapy and then at the room of high obstetrical risk. Gestation ends after 33 weeks, via Caesarean surgery with the product of a female newborn with the proper weight for her age, and APGAR of 8 and 9, who is admitted in the neonatology service for vigilance. Both, mother and daughter, are discharged in good physical conditions on the fifth day of the post-surgical period. Several articles and publications recommend a conservative treatment in such cases, many of which do not offer other alternatives. However, thanks to concept innovation and improved surgical techniques and abilities, several patients with myomatosis, which complicates pregnancy mainly with alterations in the urinary function, have undergone myomectomies, and gestation has proceeded successfully; never-theless, risk of complications is evident, as it has also been reported in recent articles about unfavorable and fateful outcomes.

Keywords : Myomatosis uterine and pregnancy; Myomectomy.

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