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Preoperative Magnetic Resonance Imaging and Antepartum Myomectomy of a Giant Pedunculated Leiomyoma

BACKGROUND: Antepartum myomectomy is reserved for severe pain and prevention of fetal complications. Magnetic resonance imaging has been useful in nonpregnant women for preoperative management and patient counseling. CASE: A primigravida was admitted at 12 weeks of gestation in severe acute abdominal pain with a large abdominal mass, confirmed by magnetic resonance imaging to be a pedunculated 30×27×19–cm uterine leiomyoma. An uncomplicated abdominal myomectomy was performed, incorporating a flat cup vacuum device to mobilize the mass without disturbing the gravid uterus. The patient later had an uncomplicated term vaginal delivery and healthy newborn. CONCLUSION: Magnetic resonance imaging and a flat cup vacuum device were helpful in preoperative planning and performing an uncomplicated abdominal myomectomy during pregnancy, respectively.