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Case ReportUterine Fibroid Torsion during Pregnancy A Case ofLaparotomic Myomectomy at 18 Weeksrsquo Gestation withSystematic Review of the Literature
Annachiara Basso1 Mariana Rita Catalano1 Giuseppe Loverro1
Serena Nocera1 Edoardo Di Naro1 Matteo Loverro1
Mariateresa Natrella2 and Salvatore Andrea Mastrolia1
1Department of Obstetrics and Gynecology Azienda Ospedaliera Universitaria Policlinico di Bari School of MedicineUniversita degli Studi di Bari ldquoAldo Morordquo Bari Italy2School of Nursing Azienda Ospedaliera Universitaria Policlinico di Bari School of MedicineUniversita degli Studi di Bari ldquoAldo Morordquo Bari Italy
Correspondence should be addressed to Salvatore Andrea Mastrolia mastroliasagmailcom
Received 15 January 2017 Revised 17 March 2017 Accepted 20 March 2017 Published 24 April 2017
Academic Editor Maria Grazia Porpora
Copyright copy 2017 Annachiara Basso et al This is an open access article distributed under the Creative Commons AttributionLicense which permits unrestricted use distribution and reproduction in any medium provided the original work is properlycited
Uterine myomas are the most common benign growths affecting female reproductive system occurring in 20ndash40 of womenwhereas the incidence rate in pregnancy is estimated from 01 to 39 The lower incidence in pregnancy is due to the associationwith infertility and low pregnancy rates and implantation rates after in vitro fertilization treatment Uterine myomas usually areasymptomatic during pregnancy However occasionally pedunculated fibroids torsion or other superimposed complications maycause acute abdominal pain There are many controversies in performing myomectomy during cesarean section because of therisk of hemorrhage Nevertheless the majority of indication arises before labor and delivery due to acute symptoms leading to adiscussion regarding the need for intervention during pregnancy Therefore we present a case of successful multiple laparotomicmyomectomy at 17 + 2 weeks of gestational age and a systematic review of the literature in order to clarify the approach to thispathologic condition and its effect on pregnancy outcome
1 Introduction
Uterine myomas are the most common benign growthsaffecting female reproductive system occurring in 20ndash40of women [1] whereas the incidence rate in pregnancy isestimated from 01 to 39The lower incidence in pregnancyis due to the association with infertility and low pregnancyrates and implantation rates after in vitro fertilization treat-ment [2] Uterine myomas usually are asymptomatic dur-ing pregnancy However occasionally pedunculated fibroidstorsion or other superimposed complications may causeacute abdominal pain Urinary and gastroenteric symptomsmay occur due to the rapid increase in size in reason ofhyperestrogenic environment and consequently compres-sion and displacement of surrounding organs Additionallyfibroids predispose to pregnancy complications including
early miscarriage antepartum bleeding preterm labor pre-mature rupture of membranes fetal malpresentations labordystocia and postpartum hemorrhage
Conservative management with anti-inflammatory ther-apy is considered a gold standard and surgery is generallyavoided during pregnancy because of the risks of hysterec-tomy secondary to severe hemorrhage pregnancy injuryand pregnancy loss [3] The main conditions that induceinevitably the surgical procedure are the torsion of peduncu-lated fibroids or rare cases of necrosis resultant inflammatoryperitoneal reaction and finally if symptoms persist after72 hours of pharmacological therapy [4ndash7] Therefore thediagnosis needs a particular attention for the appropriatemanagement choice Surgical removal fibroids in pregnancycan be performed by laparotomy or laparoscopy techniquetaking into account the volume and location of nodules [1 8]
HindawiCase Reports in Obstetrics and GynecologyVolume 2017 Article ID 4970802 11 pageshttpsdoiorg10115520174970802
2 Case Reports in Obstetrics and Gynecology
Laparoscopy can be considered in selected cases such assmall subserous pedunculated myomas
There are many controversies in performing myomec-tomy during cesarean section because of the risk of hem-orrhage [3] Nevertheless the majority of indication arisesbefore labor and delivery due to acute symptoms leadingto a discussion regarding the need for intervention duringpregnancy
Therefore we present a case of successful multiple laparo-tomic myomectomy at 17 + 2 weeks of gestational age anda systematic review of the literature in order to clarifythe approach to this pathologic condition and its effect onpregnancy outcome
2 Case Report
Uterinemyomas are usually asymptomatic during pregnancyHowever pedunculated fibroids torsion may occasionallycause acute abdominal pain [1]
Most cases of laparotomic myomectomy described inliterature have been performed during a cesarean section dueto the risk of managing them surgically at low gestational age[2ndash4] We present a case of a successful multiple laparotomicmyomectomy during the second trimester of pregnancy
A 36-year-old morbidly obese primigravida presentedat our emergency room at 17 + 0 weeks of gestational agecomplaining of abdominal pain At clinical examination theuterus appeared to be of higher volume compared to thegestational age the abdomen was painful but treatable andthe obstetrical examination was normalThe patient was thenreferred to USUnit of our Department for further evaluationThe sonographic assessment revealed the presence of threesubserous uterine myomas located on anterior wall (maxi-mum diameter 132 cm) the right wall (maximum diameter126 cm) and the left wall (maximum diameter 117 cm) ofthe uterus respectively Allmyomaswere vacuolated inside asfor suspected necrosis The scan also showed other multiplemyomas less than 3 cm in size Vital signs were monitored(blood pressure 14090mmHg maternal heart rate 124 bmpSO2 94 apyretic) Amniotic fluid was normal and fetalwell-being was preserved Thus the patient was admitted tothe High-Risk-Pregnancy Unit When collecting the medicalhistory the first trimester ultrasound scan performed at 11weeksrsquo gestation revealed the presence of the same lesionswith a size of 108 cm 102 cm and 614 cm respectively
Laboratory studies demonstrated rising inflammatorymarkers (C-reactive protein 354mgLWBC 1692times 103 120583L)
Due to the persistence of the symptoms despite of twodays of analgesic antispastic and antibiotic therapy aftermultidisciplinary discussion and a thorough counseling toinform the parents of the surgical and postoperative risksconnected with uterine surgery during the gestation thepatient underwent surgery Laparotomy approach by longitu-dinal skin incision considering the volume and the positionof the myomas was performed under general anesthesiaThree huge bulky subserous pedunculated myomas were evi-denced the largest located at the uterine fundus with amaxi-mum diameter of 15 cm and a torsion of its pedicle (Figure 1)Furthermore intra-abdominal adhesions were found within
Figure 1 Myoma of the uterine fundus with evidence of torsion ofits pedicle
peritoneal cavity Blunt dissection was undertaken to free theomentum and look for the appendix which was normal Thethree large myomas evidenced by ultrasound were removedand sent for pathologic examination A pelvic drainage wasleft and removed 24 hours postoperatively Pathology showedwidespread phenomena of necrosis especially in the myomawith torsion of its pedicle
During the following nine days the patient receivedantibiotics low molecular heparin and progesterone andfetal heartbeat was checked daily Considering the improve-ment in clinical condition the patient was discharged with anindication to treatment with progesterone and lowmolecularheparin
Three weeks later at 21 weeksrsquo gestation the patientwas admitted again due to abdominal pain Obstetricalevaluation revealed cervical effacement and the transvagi-nal ultrasound scan showed a reduction of cervical length(18mm) funneling and sludge An ultrasound scan wasperformed showing good fetal variables Consequently thetherapy with progesterone was increased The patient hada positive vaginal culture for Staphylococcus haemolyticusurine culture was negative and C-reactive protein resulted tobe positiveTherefore antibiotic therapy withmacrolides wasgiven according to antibiogram result A cervical cerclagewas proposed to the patient but she refused to undergo theprocedure
Hospitalization lasted for seven days then thewomanwasdischarged due to an improvement of her clinical conditionThe patient underwent obstetric evaluation every two weeksuntil she presented in labor and delivered vaginally at 38+ 1 weeksrsquo gestation a healthy female newborn of 2940 gappropriate for gestational age according to national growthcurves [9] Apgar score was 910 at 11015840 and 51015840 respectively
3 Data Source and Literature Search
To identify potentially eligible studies we searched PubMedScopus and Cochrane Library (all from inception to 16March 2017) No language restrictions were initially appliedWe used a combination of key words and text words repre-sented by ldquomyomectomyrdquo ldquomyomardquo and ldquopregnancyrdquo
Two reviewers (Annachiara Basso and Mariana RitaCatalano) independently screened the titles and abstracts of
Case Reports in Obstetrics and Gynecology 3
1855 records identiedthrough database searching
1611 records aer duplicates were removed
40 full-text articles excludedReasons for exclusion31 linguistic reason9 not retrievable aer international librarian search
104 full-text articlesassessed for eligibility
63 studies included
1611 records screened 1508 records excluded
Iden
tica
tion
Scre
enin
gEl
igib
ility
Inclu
sion
Figure 2 Study selection process
records retrieved through database searches Both reviewersrecommended studies for the full-text review The screenof full-text articles recommended by at least one reviewerwas done independently by the same two reviewers andassessed for inclusion in the systematic review Disagree-ments between reviewers were resolved by consensus For allfull-text manuscripts reference lists were analyzed in orderto find additional eligible studies
4 Results
Theelectronic database search provided a total of 1855 resultsAfter duplicate exclusion there were 1611 citations left Ofthese 1508 were not relevant to the review based on titleand abstract screening 103 studies were considered for full-text assessment of which 40 were excluded for the followingreasons we could not translate 31 articles while nine paperscould not be retrieved even after international librariansearch
Overall 63 [3ndash6 10ndash67] articles were incorporated forfurther assessment The study selection process is shown inFigure 2 The main characteristics of the selected studies areincluded in Table 1
5 Discussion
Our review included 197 women undergoing myomectomyduring pregnancy The procedure was successful in 184women while in the remaining 13 cases a miscarriage or fetaldemise happened after the myomectomy
In 14 cases a laparoscopic approach was chosen in onecase there was a vaginal surgery while all the other casesfor which the surgical information was available underwentlaparotomy These data confirm that the most used surgicalintervention for myomas during pregnancy is the laparotomyroute
Maternal outcomes were favorable after myomectomywith only two episodes of hemoperitoneum [33 67] one uter-ine abscess [39] and only one woman requiring perioperativeblood transfusion [61]
Moreover the analysis of all reports was limited by twofactors (1) the heterogeneity of diagnostic information aswell as descriptive data connected to operation and pathologyexamination which did not allow clear categorization of thepathology preoperatively and postoperatively and (2) thelarge amount of missing or unreported data
6 Conclusion
Myomectomy is a feasible procedure if performed duringpregnancy Candidates need to be chosen carefully amongthose with symptomatic myomas since abdominal surgeryduring pregnancy can be associated with an increased riskfor the development of the great obstetrical syndromesespecially preterm labor and delivery
Disclosure
This paper has been presented in part at the 19th NationalCongress of the Italian Society of Perinatal Medicine (Societa
4 Case Reports in Obstetrics and Gynecology
Table1Ch
aracteris
ticso
fthe
relevant
studies
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)
DeC
arolisetal
2001
18
nd13
LPT
8CS
39883150
gnd
23LP
T40
CS38
882670
gnd
19LP
T14
VD
36893080
gnd
17LP
T21
CS38
893060
gnd
19LP
T15
Fetald
emise
at19
weeks
nd20
LPT
6VD
41992970
gnd
19LP
T12
CS39
793180
gnd
8LP
T9
CS40
993300
gnd
12LP
T8
CS38
9102780g
nd17
LPT
24CS
38993900
gnd
15LP
T10
CS40
8103170g
nd17
LPT
13CS
399103100g
nd6
LPT
15nd
ndnd
nd20
LPT
8CS
399102860g
nd10
LPT
16CS
409103500g
nd16
LPT
10CS
399103930g
nd13
LPT
14CS
39993180
gnd
7LP
T15
CS38
910
-2550g
Dom
enicietal
2014
116
16LP
T20
CS38
89-3
250g
Michalase
tal
1995
114
15LP
T20
CS39
2800
g
Danzere
tal2001
112
12LP
T10
CS37
9103235g
9102810g
Lozzae
tal2011
112
16LP
T18
CS36
992280
gJooetal2001
18
25LP
T12
CS40
3600
g
Celik
etal2002
5
nd22
LPT
13CS
386+minus11
103200g
nd18
LPT
10CS
386+minus11
93400
gnd
20LP
T12
CS386+minus11
10360
0gnd
16LP
T15
CS386+minus11
83100
gnd
13LP
T20
CS386+minus11
92800
gHasbargen
etal
2002
118
18LP
T15
CS36
892495
g
Umezurikea
ndFeyi-W
aboso2005
119
19LP
T32
VD
388103500g
Usifoetal2007
113
13LP
T17
CS38
3990
gSuwandinataetal
2009
1nd
18LP
Tnd
CS37
892950
g
Case Reports in Obstetrics and Gynecology 5
Table1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)Bh
atlaetal2009
18
19LP
T28
VD
382740
gLeite
etal2009
11sttrim
ester
17LP
T10
CS39
9103315g
Isabuetal2010
114
14LP
Tnd
CS37
2700
gLeachetal2011
111
11LP
T14
CS40
994356
gDoerga-
Bachasingh
etal
2012
19
10LP
T15
CS37
nd
Jhaltaetal2016
113
13LP
T16
VD
39810300
0gKo
smidisetal
2015
110
10LP
S8
ndnd
nd
Saccardi
etal2015
19
15LP
S24
CS41
4460
g72
Obara
etal2014
16
13VA
G6
VD
402775
gCu
rrieetal2013
111
11LP
S8
ndnd
ndKo
bayashietal
2013
121
21LP
T8
CS37
2730
g
MacCioetal2012
38
19LP
S11
CS39
3150
g20
20LP
S10
VD
403310g
2020
LPS
ndCS
393050
gShafiee
etal2012
115
21LP
S15
CS38
ndArdovinoetal
2011
114
14LP
S6
VD
403216g
MullerV
ranjes
etal
114
18LP
T35
CS33
1010
1750g
728
Sonetal2011
118
18LP
S9
VD
393740
gKa
sum
2010
115
15LP
T9
VD
38nd
Fanfanietal2010
125
25LP
S9
VD
402950
gAd
eyem
ietal
2007
119
19LP
T30
VD
397103500g
Okonk
woand
Udigw
e2007
119
24LP
Tnd
CSnd
nd
Draceaa
ndCod
reanu2006
112
13LP
T24
VD
ndnd
Melgratietal2005
124
24LP
S7
VD
3999
6 Case Reports in Obstetrics and GynecologyTa
ble1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)Sentilh
esetal
2003
117
17LP
S5
CS37
3530
g
Lolis
etal2003
13
nd16
LPT
ndCS
373340
gnd
15LP
Tnd
CS39
3600
gnd
19LP
Tnd
CS37
2970
gnd
16LP
Tnd
CS36
3000
gnd
15LP
Tnd
Fetald
emise
at15
weeks
nd15
LPT
ndCS
372740
gnd
16LP
Tnd
CS38
3180
gnd
16LP
Tnd
CS39
3515g
nd16
LPT
ndCS
393190
gnd
19LP
Tnd
CS38
2920
gnd
17LP
Tnd
CS38
3520
gnd
16LP
Tnd
CS38
3000
gnd
15LP
Tnd
CS29
1606
g
Don
neze
tal2002
1Be
fore
pregnancy
25LP
T22
CS35
2280
g
Williamson
1908
122
22LP
T32
VD
23Neonatald
eath
Stew
art1906
120
20LP
T24
VD
40nd
Wittichetal2000
112
15LP
T20
CS37
993275
gMajid
etal1997
117
18LP
T24
Fetald
emise
19weeks
Algarae
tal2015
118
18LP
S7
VD
24nd
Lockyer1914
121
21LP
Tnd
VD
402300
g
vonHoff
mann1911
316
16LP
Tnd
VD
403630
g22
25LP
Tnd
Fetald
emise
at25
weeks
1415
LPT
ndVD
40nd
And
rews1910
1Be
fore
pregnancy
9LP
Tnd
VD
40nd
Swayne1908
220
20LP
Tnd
ndnd
nd16
16LP
Tnd
VD
24nd
Doran1906
120
21LP
T10
VD
40nd
Evans1899
120
20LP
T7
ndnd
ndEx
acou
stosa
ndRo
sati
1993
13nd
lt26
ndnd
NG
40(8)pretermgt
32(5)
nd
Burton
etal1989
8
nd13
LPT
18VD
40nd
nd15
LPT
14Fetald
emise
15weeks
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5nd
ndnd
Rella
etal1980
110
12LP
Tnd
VD
27Neonatald
eath
Case Reports in Obstetrics and Gynecology 7Ta
ble1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)Pelosietal1995
113
15LP
S6
CS39
ndPelissie
r-Ko
morek
etal2012
110
13LP
T22
VD
352280
g
Mollicae
tal1996
188ndash17
10ndash19
LPT
gt10
CS(17)V
D(1)
ndgt7(18)gt
2500
g(17)lt
2500
g(1)
Febo
etal1997
3nd
12ndash19
LPT
NG
CS(2)abortio
n(1)
37-38
nd
Bonito
etal2007
5nd
9ndash15
LPT
35ndash145
CS(2)VD(3)
382
9+minus083
3200ndash4
072g
Vazqu
ezCa
macho
etal2009
17
16LP
T62
VD
4099
Makar
etal1989
112
17LP
T13500
gCS
38993950
gHorno
Liria
1962
116
16LP
Tnd
VD
403600
gAlanise
tal2008
17
12LP
T30
VD
382330
g
Ardizzone1955
27
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
88
LPT
ndMisc
arria
geat9weeks
2424
LPT
ndFetald
emise
at25
weeks
88
LPT
ndMisc
arria
geat8weeks
1616
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at14
weeks
2020
LPT
ndnd
ndnd
1616
LPT
ndnd
ndnd
2020
LPT
ndnd
ndnd
2020
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at13
weeks
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at13
weeks
1212
LPT
ndnd
ndnd
1616
LPT
ndFetald
emise
at17
weeks
88
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at12
weeks
1212
LPT
ndnd
ndnd
8 Case Reports in Obstetrics and Gynecology
Table1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)
Cozzi1967
16
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
nd16
LPT
ndVD
38nd
nd8
LPT
ndVD
40nd
nd12
LPT
ndVD
38nd
nd8
LPT
ndVD
40nd
nd16
LPT
ndVD
40nd
nd20
LPT
ndVD
36nd
nd8
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd16
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
Rochetetal1964
14nd
ndLP
T10
ndnd
ndSciann
ameo
etal
1996
120
20LP
T4
ndnd
nd
ndnot
determ
inedC
Scesarean
section
VDvaginaldeliveryLP
TlaparotomyLP
Slap
aroscopyV
AGvaginalsurgery
Case Reports in Obstetrics and Gynecology 9
Italiana di Medicina Perinatale SIMP) Naples (Italy) 19ndash21January 2017
Conflicts of Interest
The authors declare that there are no conflicts of interest
References
[1] S G Vitale A Tropea D Rossetti M Carnelli and A CiancildquoManagement of uterine leiomyomas in pregnancy review ofliteraturerdquo Updates in Surgery vol 65 no 3 pp 179ndash182 2013
[2] S K Sunkara M Khairy T El-Toukhy Y Khalaf and ACoomarasamy ldquoThe effect of intramural fibroids without uter-ine cavity involvement on the outcome of IVF treatment asystematic review and meta-analysisrdquo Human Reproductionvol 25 no 2 pp 418ndash429 2010
[3] V Lozza A Pieralli S Corioni M Longinotti and C PennaldquoMultiple laparotomic myomectomy during pregnancy a casereportrdquo Archives of Gynecology and Obstetrics vol 284 no 3pp 613ndash616 2011
[4] L Domenici V Di Donato M L Gasparri F Lecce J Caccettaand P B Panici ldquoLaparotomic myomectomy in the 16th weekof pregnancy a case reportrdquo Case Reports in Obstetrics andGynecology 5 pages 2014
[5] D E Lolis S N KalantaridouGMakrydimas et al ldquoSuccessfulmyomectomy during pregnancyrdquoHuman Reproduction vol 18no 8 pp 1699ndash1702 2003
[6] S De Carolis G Fatigante S Ferrazzani et al ldquoUterinemyomectomy in pregnant womenrdquo Fetal Diagnosis and Ther-apy vol 16 no 2 pp 116ndash119 2001
[7] N Bhatla B B Dash A Kriplani and N Agarwal ldquoMyomec-tomy during pregnancy a feasible optionrdquo Journal of Obstetricsand Gynaecology Research vol 35 no 1 pp 173ndash175 2009
[8] A Cagnacci D Pirillo S Malmusi S Arangino C Alessan-drini and A Volpe ldquoEarly outcome of myomectomy by laparo-tomy minilaparotomy and laparoscopically assisted minila-parotomy A randomized prospective studyrdquoHuman Reproduc-tion vol 18 no 12 pp 2590ndash2594 2003
[9] F Parazzini S Cipriani G Bulfoni et al ldquoCentiles of weightat term birth according to maternal nationality in a northernItalian regionrdquo Italian Journal of Gynaecology and Obstetricsvol 28 no 2 pp 52ndash56 2016
[10] S P Michalas F V Oreopoulou and J S PapageorgiouldquoMyomectomy during pregnancy and caesarean sectionrdquoHuman Reproduction vol 10 no 7 pp 1869ndash1870 1995
[11] E Danzer W Holzgreve C Batukan P Miny S Tercanli and IHoesli ldquoMyomectomy during the first trimester associated withfetal limb anomalies and hydrocephalus in a twin pregnancyrdquoPrenatal Diagnosis vol 21 no 10 pp 848ndash851 2001
[12] J G Joo J Inovay M Silhavy and Z Papp ldquoSuccessfulenucleation of a necrotizing fibroid causing oligohydramniosand fetal postural deformity in the 25th week of gestation Acase reportrdquo Journal of Reproductive Medicine vol 46 no 10pp 923ndash925 2001
[13] C Celik A Acar N Cicek K Gezginc and C Akyurek ldquoCanmyomectomy be performed during pregnancyrdquo Gynecologicand Obstetric Investigation vol 53 no 2 pp 79ndash83 2002
[14] U Hasbargen A Strauss M Summerer-Moustaki et alldquoMyomectomy as a pregnancy-preserving option in the care-fully selected patientrdquo Fetal Diagnosis and Therapy vol 17 no2 pp 101ndash103 2002
[15] C Umezurike and P Feyi-Waboso ldquoSuccessful myomectomyduring pregnancy a case reportrdquo Reproductive Health vol 2no 1 2005
[16] F Usifo R Macrae R Sharma I O Opemuyi and BOnwuzurike ldquoSuccessful myomectomy in early second trimes-ter of pregnancyrdquo Journal of Obstetrics and Gynaecology vol 27no 2 pp 196ndash197 2007
[17] F S Suwandinata S E Gruessner C O Omwandho and H RTinneberg ldquoPregnancy-preserving myomectomy preliminaryreport on a new surgical techniquerdquo European Journal ofContraception and Reproductive Health Care vol 13 no 3 pp323ndash326 2008 Erratum in European Journal of Contraceptionand Reproductive Health Care vol 13 no 4 article 438 2008
[18] G K Leite H A Korkes T Viana Ade A Pitorri G Kenj andN Sass ldquoMyomectomy in the second trimester of pregnancycase reportrdquo Revista Brasileira De Ginecologia E Obstetricia vol32 no 4 pp 198ndash201 2010
[19] P Isabu J Eigbefoh F Okogbo S Okunsanya and R EifediyildquoMyomectomy during second trimester pregnancy a casereportrdquo The Nigerian Postgraduate Medical Journal vol 17 no4 pp 324ndash326 2010
[20] K Leach L Khatain and K Tocce ldquoFirst trimester myomec-tomy as an alternative to termination of pregnancy in a womanwith a symptomatic uterine leiomyoma a case reportrdquo Journalof Medical Case Reports vol 5 article 571 2011
[21] S Doerga-Bachasingh V Karsdorp G Yo R Van Der Weidenand M Van Hooff ldquoSuccessful myomectomy of a bleedingmyoma in a twin pregnancyrdquo JRSM Short Reports vol 3 no 2article 13 2012
[22] P Jhalta S G Negi andV Sharma ldquoSuccessful myomectomy inearly pregnancy for a large asymptomatic uterine myoma casereportrdquo Pan African Medical Journal vol 13 no 24 article 228Article ID 228 2016
[23] C Kosmidis G Pantos C Efthimiadis I Gkoutziomitrou EGeorgakoudi and G Anthimidis ldquoLaparoscopic excision of apedunculated uterine leiomyoma in torsion as a cause of acuteabdomen at 10 weeks of pregnancyrdquo American Journal of CaseReports vol 16 pp 505ndash508 2015
[24] C Saccardi S Visentin M Noventa E Cosmi P Litta and SGizzo ldquoUncertainties about laparoscopic myomectomy duringpregnancy a lack of evidence or an inherited misconceptionA critical literature review starting from a peculiar caserdquoMinimally Invasive Therapy and Allied Technologies vol 24 no4 pp 189ndash194 2015
[25] M Obara Y Hatakeyama and Y Shimizu ldquoVaginal myomec-tomy for semipedunculated cervical myoma during pregnancyrdquoAmerican Journal of Perinatology Reports vol 4 no 1 pp 37ndash402014
[26] A Currie E Bradley M McEwen N Al-Shabibi and P DWillson ldquoLaparoscopic approach to fibroid torsion presentingas an acute abdomen in pregnancyrdquo Journal of the Society ofLaparoendoscopic Surgeons vol 17 no 4 pp 665ndash667 2013
[27] F Kobayashi E Kondoh J Hamanishi Y Kawamura KTatsumi and I Konishi ldquoPyomayoma during pregnancy a casereport and review of the literaturerdquo Journal of Obstetrics andGynaecology Research vol 39 no 1 pp 383ndash389 2013
[28] A MacCio C Madeddu P Kotsonis et al ldquoThree cases oflaparoscopic myomectomy performed during pregnancy for
10 Case Reports in Obstetrics and Gynecology
pedunculated uterine myomasrdquo Archives of Gynecology andObstetrics vol 286 no 5 pp 1209ndash1214 2012
[29] M Shafiee M Nor Azlin and D Arifuddin ldquoA successfulantenatal myomectomyrdquo Malaysian Family Physician vol 31no 7(2-3) pp 42ndash45 2012
[30] M Ardovino I Ardovino M A Castaldi A Monteverde NColacurci and L Cobellis ldquoLaparoscopic myomectomy of asubserous pedunculated fibroid at 14 weeks of pregnancy a casereportrdquo Journal of Medical Case Reports vol 5 article 545 2011
[31] A Muller Vranjes S Sijanovic D Vidosavljevic Z Kasac andK Abicic Zuljevic ldquoSurgical treatment of large smooth muscletumor of uncertain malignant potential during pregnancyrdquoMedicinski Glasnik Journal vol 8 no 2 pp 290ndash292 2011
[32] C E Son J S Choi J H Lee S W Jeon J W Bae and S SSeo ldquoA case of laparoscopic myomectomy performed duringpregnancy for subserosal uterine myomardquo Journal of Obstetricsand Gynaecology vol 31 no 2 pp 180ndash181 2011
[33] M Kasum ldquoHemoperitoneum caused by a bleeding myoma inpregnancyrdquo Acta Clinica Croatica vol 49 no 2 pp 197ndash2002010
[34] F Fanfani C Rossitto A Fagotti P Rosati V Gallotta andG Scambia ldquoLaparoscopic myomectomy at 25 weeks of preg-nancy case reportrdquo Journal of Minimally Invasive Gynecologyvol 17 no 1 pp 91ndash93 2010
[35] A S Adeyemi S E Akinola and A I Isawumi ldquoAntepartummyomectomywith a live term deliverymdasha case reportrdquoNigerianJournal of Clinical Practice vol 10 no 4 pp 346ndash348 2007
[36] J E N Okonkwo and G O Udigwe ldquoMyomectomy in preg-nancyrdquo Journal of Obstetrics and Gynaecology vol 27 no 6 pp628ndash630 2007
[37] L Dracea and D Codreanu ldquoVaginal birth after extensivemyomectomy during pregnancy in a 39-year-old nulliparouswomanrdquo Journal of Obstetrics and Gynaecology vol 26 no 4pp 374ndash375 2006
[38] L Melgrati A Damiani G Franzoni M Marziali and FSesti ldquoIsobaric (gasless) laparoscopic myomectomy duringpregnancyrdquo Journal of Minimally Invasive Gynecology vol 12no 4 pp 379ndash381 2005
[39] L Sentilhes F Sergent E Verspyck A Gravier H Roman andL Marpeau ldquoLaparoscopic myomectomy during pregnancyresulting in septic necrosis of the myometriumrdquo BJOG AnInternational Journal of Obstetrics and Gynaecology vol 110 no9 pp 876ndash878 2003
[40] J Donnez C Pirard M Smets R Polet C Feger and JSquifflet ldquoUnusual growth of a myoma during pregnancyrdquoFertility and Sterility vol 78 no 3 pp 632ndash633 2002
[41] HWilliamson ldquoEnucleation during the seventh lunarmonth ofpregnancy of a uterine fibro-myomardquo Proceedings of the RoyalSociety of Medicine vol 1 pp 73ndash78 1908
[42] J Stewart ldquoEnucleation of fibro-myoma of uterus duringpregnancyrdquo British Medical Journal vol 1 no 2358 pp 548ndash549 1906
[43] A C Wittich E R Salminen M K Yancey and G RMarkenson ldquoMyomectomy during early pregnancyrdquo MilitaryMedicine vol 165 no 2 pp 162ndash164 2000
[44] M Majid G Q Khan and L MWei ldquoInevitable myomectomyin pregnancyrdquo Journal of Obstetrics and Gynaecology vol 17 no4 pp 377ndash378 1997
[45] A C Algara A G Rodrıguez A C Vazquez et al ldquoLaparo-scopic approach for fibroid removal at 18 weeks of pregnancyrdquoSurgical Technology International vol 27 pp 195ndash197 2015
[46] C Lockyer ldquoMultiple myomectomy in the sixth month ofpregnancy labour at termrdquo Proceedings of the Royal Society ofMedicine vol 7 pp 221ndash225 1914
[47] C A von Hoffmann ldquoAbdominal myomectomy during preg-nancyrdquoCalifornia State Journal ofMedicine vol 9 no 5 pp 197ndash200 1911
[48] H R Andrews ldquoMyomectomy during pregnancyrdquo Proceedingsof the Royal Society of Medicine vol 3 pp 164ndash166 1910
[49] WC Swayne ldquoAbdominal myomectomy during pregnancyrdquoProceedings of the Royal Society of Medicine vol 1 pp 129ndash1321908
[50] A Doran ldquoMyomectomy during pregnancy and labour at termin an elderly primipara with notes on similar casesrdquo BritishMedical Journal vol 2 no 2395 pp 1446ndash1447 1906
[51] H M Evans ldquoA case of myomectomy for subperitoneal myomacomplicating pregnancyrdquo British Medical Journal vol 2 no2033 p 1673 1899
[52] C Exacoustos and P Rosati ldquoUltrasound diagnosis of uterinemyomas and complications in pregnancyrdquoObstetrics and Gyne-cology vol 82 no 1 pp 97ndash101 1993
[53] C A Burton D A Grimes and C M March ldquoSurgicalmanagement of leiomyomata during pregnancyrdquoObstetrics andGynecology vol 74 no 5 pp 707ndash709 1989
[54] R Rella E Bonfadini Bossi and D Fagnani ldquoMyomectomy inpregnancy Description of an interesting clinical caserdquoMinervaGinecologica vol 32 no 4 pp 267ndash269 1980
[55] M A Pelosi M A Pelosi III and S Giblin ldquoLaparoscopicremoval of a 1500-g symptomatic myoma during the secondtrimester of pregnancyrdquo American Association of GynecologicLaparoscopists vol 2 no 4 pp 457ndash462 1995
[56] A Pelissier-Komorek J Hamm S Bonneau E Derniaux CHoeffel-Fornes and O Graesslin ldquoMyoma and pregnancywhen medical treatment is not sufficientrdquo Journal de Gynecolo-gie Obstetrique et Biologie de la Reproduction vol 41 no 3 pp307ndash310 2012
[57] G Mollica L Pittini E Minganti G Perri and F PansinildquoElective uterine myomectomy in pregnant womenrdquo Clinicaland Experimental Obstetrics and Gynecology vol 23 no 3 pp168ndash172 1996
[58] G Febo M Tessarolo L Leo S Arduino T Wierdis and LLanza ldquoSurgical management of leiomyomata in pregnancyrdquoClinical and ExperimentalObstetrics andGynecology vol 24 no2 pp 76ndash78 1997
[59] M Bonito L Gulemı R Basili and D Roselli ldquoMyomectomyduring the first and second trimester of pregnancyrdquoClinical andExperimental Obstetrics and Gynecology vol 34 no 3 pp 149ndash150 2007
[60] E E Vazquez Camacho E Cabrera Carranco and R GSanchez Herrera ldquoPedunculated twisted myoma and preg-nancy Case reportrdquoGinecologia y Obstetricia de Mexico vol 77no 9 pp 441ndash444 2009
[61] A P Makar E A Schatteman I B Vergote and E DesmedtldquoMyomectomy during pregnancy uncommon case reportrdquoActa Chirurgica Belgica vol 89 no 4 pp 212ndash214 1989
[62] R Horno Liria ldquoMyomectomy and pregnancyrdquo Rev Esp ObstetGinecol vol 19 pp 214ndash218 1962
[63] M C Alanis A Mitra and N Koklanaris ldquoPreoperativemagnetic resonance imaging and antepartummyomectomy of agiant pedunculated leiomyomardquoObstetrics and Gynecology vol111 no 2 part 2 pp 577ndash579 2008
Case Reports in Obstetrics and Gynecology 11
[64] G Ardizzone ldquoClinical and statistical considerations of 27cases of myomectomy in pregnancyrdquo Rivista di Ostetricia eGinecologia vol 10 no 12 pp 848ndash860 1955
[65] M Cozzi ldquoMyomectomy in pregnancyrdquo Quaderni di ClinicaOstetrica e Ginecologica vol 22 no 3 pp 171ndash180 1967
[66] Y Rochet M Cognat D Dargent and E Pollosson ldquoOnmyomectomy during pregnance (apropos of 14 observations)rdquoBulletin de la Federation des Societes de Gynecologie etDobstetrique de Langue Francaise vol 16 pp 462ndash463 1964
[67] F Sciannameo G Madami C Madami et al ldquoTorsion ofuterine fibroma associated with inguinal incarcerated hernia inpregnancy Case reportrdquo Minerva Ginecologica vol 48 no 11pp 501ndash504 1996
Submit your manuscripts athttpswwwhindawicom
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
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Disease Markers
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OncologyJournal of
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Oxidative Medicine and Cellular Longevity
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PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
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Computational and Mathematical Methods in Medicine
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Research and TreatmentAIDS
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Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
2 Case Reports in Obstetrics and Gynecology
Laparoscopy can be considered in selected cases such assmall subserous pedunculated myomas
There are many controversies in performing myomec-tomy during cesarean section because of the risk of hem-orrhage [3] Nevertheless the majority of indication arisesbefore labor and delivery due to acute symptoms leadingto a discussion regarding the need for intervention duringpregnancy
Therefore we present a case of successful multiple laparo-tomic myomectomy at 17 + 2 weeks of gestational age anda systematic review of the literature in order to clarifythe approach to this pathologic condition and its effect onpregnancy outcome
2 Case Report
Uterinemyomas are usually asymptomatic during pregnancyHowever pedunculated fibroids torsion may occasionallycause acute abdominal pain [1]
Most cases of laparotomic myomectomy described inliterature have been performed during a cesarean section dueto the risk of managing them surgically at low gestational age[2ndash4] We present a case of a successful multiple laparotomicmyomectomy during the second trimester of pregnancy
A 36-year-old morbidly obese primigravida presentedat our emergency room at 17 + 0 weeks of gestational agecomplaining of abdominal pain At clinical examination theuterus appeared to be of higher volume compared to thegestational age the abdomen was painful but treatable andthe obstetrical examination was normalThe patient was thenreferred to USUnit of our Department for further evaluationThe sonographic assessment revealed the presence of threesubserous uterine myomas located on anterior wall (maxi-mum diameter 132 cm) the right wall (maximum diameter126 cm) and the left wall (maximum diameter 117 cm) ofthe uterus respectively Allmyomaswere vacuolated inside asfor suspected necrosis The scan also showed other multiplemyomas less than 3 cm in size Vital signs were monitored(blood pressure 14090mmHg maternal heart rate 124 bmpSO2 94 apyretic) Amniotic fluid was normal and fetalwell-being was preserved Thus the patient was admitted tothe High-Risk-Pregnancy Unit When collecting the medicalhistory the first trimester ultrasound scan performed at 11weeksrsquo gestation revealed the presence of the same lesionswith a size of 108 cm 102 cm and 614 cm respectively
Laboratory studies demonstrated rising inflammatorymarkers (C-reactive protein 354mgLWBC 1692times 103 120583L)
Due to the persistence of the symptoms despite of twodays of analgesic antispastic and antibiotic therapy aftermultidisciplinary discussion and a thorough counseling toinform the parents of the surgical and postoperative risksconnected with uterine surgery during the gestation thepatient underwent surgery Laparotomy approach by longitu-dinal skin incision considering the volume and the positionof the myomas was performed under general anesthesiaThree huge bulky subserous pedunculated myomas were evi-denced the largest located at the uterine fundus with amaxi-mum diameter of 15 cm and a torsion of its pedicle (Figure 1)Furthermore intra-abdominal adhesions were found within
Figure 1 Myoma of the uterine fundus with evidence of torsion ofits pedicle
peritoneal cavity Blunt dissection was undertaken to free theomentum and look for the appendix which was normal Thethree large myomas evidenced by ultrasound were removedand sent for pathologic examination A pelvic drainage wasleft and removed 24 hours postoperatively Pathology showedwidespread phenomena of necrosis especially in the myomawith torsion of its pedicle
During the following nine days the patient receivedantibiotics low molecular heparin and progesterone andfetal heartbeat was checked daily Considering the improve-ment in clinical condition the patient was discharged with anindication to treatment with progesterone and lowmolecularheparin
Three weeks later at 21 weeksrsquo gestation the patientwas admitted again due to abdominal pain Obstetricalevaluation revealed cervical effacement and the transvagi-nal ultrasound scan showed a reduction of cervical length(18mm) funneling and sludge An ultrasound scan wasperformed showing good fetal variables Consequently thetherapy with progesterone was increased The patient hada positive vaginal culture for Staphylococcus haemolyticusurine culture was negative and C-reactive protein resulted tobe positiveTherefore antibiotic therapy withmacrolides wasgiven according to antibiogram result A cervical cerclagewas proposed to the patient but she refused to undergo theprocedure
Hospitalization lasted for seven days then thewomanwasdischarged due to an improvement of her clinical conditionThe patient underwent obstetric evaluation every two weeksuntil she presented in labor and delivered vaginally at 38+ 1 weeksrsquo gestation a healthy female newborn of 2940 gappropriate for gestational age according to national growthcurves [9] Apgar score was 910 at 11015840 and 51015840 respectively
3 Data Source and Literature Search
To identify potentially eligible studies we searched PubMedScopus and Cochrane Library (all from inception to 16March 2017) No language restrictions were initially appliedWe used a combination of key words and text words repre-sented by ldquomyomectomyrdquo ldquomyomardquo and ldquopregnancyrdquo
Two reviewers (Annachiara Basso and Mariana RitaCatalano) independently screened the titles and abstracts of
Case Reports in Obstetrics and Gynecology 3
1855 records identiedthrough database searching
1611 records aer duplicates were removed
40 full-text articles excludedReasons for exclusion31 linguistic reason9 not retrievable aer international librarian search
104 full-text articlesassessed for eligibility
63 studies included
1611 records screened 1508 records excluded
Iden
tica
tion
Scre
enin
gEl
igib
ility
Inclu
sion
Figure 2 Study selection process
records retrieved through database searches Both reviewersrecommended studies for the full-text review The screenof full-text articles recommended by at least one reviewerwas done independently by the same two reviewers andassessed for inclusion in the systematic review Disagree-ments between reviewers were resolved by consensus For allfull-text manuscripts reference lists were analyzed in orderto find additional eligible studies
4 Results
Theelectronic database search provided a total of 1855 resultsAfter duplicate exclusion there were 1611 citations left Ofthese 1508 were not relevant to the review based on titleand abstract screening 103 studies were considered for full-text assessment of which 40 were excluded for the followingreasons we could not translate 31 articles while nine paperscould not be retrieved even after international librariansearch
Overall 63 [3ndash6 10ndash67] articles were incorporated forfurther assessment The study selection process is shown inFigure 2 The main characteristics of the selected studies areincluded in Table 1
5 Discussion
Our review included 197 women undergoing myomectomyduring pregnancy The procedure was successful in 184women while in the remaining 13 cases a miscarriage or fetaldemise happened after the myomectomy
In 14 cases a laparoscopic approach was chosen in onecase there was a vaginal surgery while all the other casesfor which the surgical information was available underwentlaparotomy These data confirm that the most used surgicalintervention for myomas during pregnancy is the laparotomyroute
Maternal outcomes were favorable after myomectomywith only two episodes of hemoperitoneum [33 67] one uter-ine abscess [39] and only one woman requiring perioperativeblood transfusion [61]
Moreover the analysis of all reports was limited by twofactors (1) the heterogeneity of diagnostic information aswell as descriptive data connected to operation and pathologyexamination which did not allow clear categorization of thepathology preoperatively and postoperatively and (2) thelarge amount of missing or unreported data
6 Conclusion
Myomectomy is a feasible procedure if performed duringpregnancy Candidates need to be chosen carefully amongthose with symptomatic myomas since abdominal surgeryduring pregnancy can be associated with an increased riskfor the development of the great obstetrical syndromesespecially preterm labor and delivery
Disclosure
This paper has been presented in part at the 19th NationalCongress of the Italian Society of Perinatal Medicine (Societa
4 Case Reports in Obstetrics and Gynecology
Table1Ch
aracteris
ticso
fthe
relevant
studies
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)
DeC
arolisetal
2001
18
nd13
LPT
8CS
39883150
gnd
23LP
T40
CS38
882670
gnd
19LP
T14
VD
36893080
gnd
17LP
T21
CS38
893060
gnd
19LP
T15
Fetald
emise
at19
weeks
nd20
LPT
6VD
41992970
gnd
19LP
T12
CS39
793180
gnd
8LP
T9
CS40
993300
gnd
12LP
T8
CS38
9102780g
nd17
LPT
24CS
38993900
gnd
15LP
T10
CS40
8103170g
nd17
LPT
13CS
399103100g
nd6
LPT
15nd
ndnd
nd20
LPT
8CS
399102860g
nd10
LPT
16CS
409103500g
nd16
LPT
10CS
399103930g
nd13
LPT
14CS
39993180
gnd
7LP
T15
CS38
910
-2550g
Dom
enicietal
2014
116
16LP
T20
CS38
89-3
250g
Michalase
tal
1995
114
15LP
T20
CS39
2800
g
Danzere
tal2001
112
12LP
T10
CS37
9103235g
9102810g
Lozzae
tal2011
112
16LP
T18
CS36
992280
gJooetal2001
18
25LP
T12
CS40
3600
g
Celik
etal2002
5
nd22
LPT
13CS
386+minus11
103200g
nd18
LPT
10CS
386+minus11
93400
gnd
20LP
T12
CS386+minus11
10360
0gnd
16LP
T15
CS386+minus11
83100
gnd
13LP
T20
CS386+minus11
92800
gHasbargen
etal
2002
118
18LP
T15
CS36
892495
g
Umezurikea
ndFeyi-W
aboso2005
119
19LP
T32
VD
388103500g
Usifoetal2007
113
13LP
T17
CS38
3990
gSuwandinataetal
2009
1nd
18LP
Tnd
CS37
892950
g
Case Reports in Obstetrics and Gynecology 5
Table1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)Bh
atlaetal2009
18
19LP
T28
VD
382740
gLeite
etal2009
11sttrim
ester
17LP
T10
CS39
9103315g
Isabuetal2010
114
14LP
Tnd
CS37
2700
gLeachetal2011
111
11LP
T14
CS40
994356
gDoerga-
Bachasingh
etal
2012
19
10LP
T15
CS37
nd
Jhaltaetal2016
113
13LP
T16
VD
39810300
0gKo
smidisetal
2015
110
10LP
S8
ndnd
nd
Saccardi
etal2015
19
15LP
S24
CS41
4460
g72
Obara
etal2014
16
13VA
G6
VD
402775
gCu
rrieetal2013
111
11LP
S8
ndnd
ndKo
bayashietal
2013
121
21LP
T8
CS37
2730
g
MacCioetal2012
38
19LP
S11
CS39
3150
g20
20LP
S10
VD
403310g
2020
LPS
ndCS
393050
gShafiee
etal2012
115
21LP
S15
CS38
ndArdovinoetal
2011
114
14LP
S6
VD
403216g
MullerV
ranjes
etal
114
18LP
T35
CS33
1010
1750g
728
Sonetal2011
118
18LP
S9
VD
393740
gKa
sum
2010
115
15LP
T9
VD
38nd
Fanfanietal2010
125
25LP
S9
VD
402950
gAd
eyem
ietal
2007
119
19LP
T30
VD
397103500g
Okonk
woand
Udigw
e2007
119
24LP
Tnd
CSnd
nd
Draceaa
ndCod
reanu2006
112
13LP
T24
VD
ndnd
Melgratietal2005
124
24LP
S7
VD
3999
6 Case Reports in Obstetrics and GynecologyTa
ble1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)Sentilh
esetal
2003
117
17LP
S5
CS37
3530
g
Lolis
etal2003
13
nd16
LPT
ndCS
373340
gnd
15LP
Tnd
CS39
3600
gnd
19LP
Tnd
CS37
2970
gnd
16LP
Tnd
CS36
3000
gnd
15LP
Tnd
Fetald
emise
at15
weeks
nd15
LPT
ndCS
372740
gnd
16LP
Tnd
CS38
3180
gnd
16LP
Tnd
CS39
3515g
nd16
LPT
ndCS
393190
gnd
19LP
Tnd
CS38
2920
gnd
17LP
Tnd
CS38
3520
gnd
16LP
Tnd
CS38
3000
gnd
15LP
Tnd
CS29
1606
g
Don
neze
tal2002
1Be
fore
pregnancy
25LP
T22
CS35
2280
g
Williamson
1908
122
22LP
T32
VD
23Neonatald
eath
Stew
art1906
120
20LP
T24
VD
40nd
Wittichetal2000
112
15LP
T20
CS37
993275
gMajid
etal1997
117
18LP
T24
Fetald
emise
19weeks
Algarae
tal2015
118
18LP
S7
VD
24nd
Lockyer1914
121
21LP
Tnd
VD
402300
g
vonHoff
mann1911
316
16LP
Tnd
VD
403630
g22
25LP
Tnd
Fetald
emise
at25
weeks
1415
LPT
ndVD
40nd
And
rews1910
1Be
fore
pregnancy
9LP
Tnd
VD
40nd
Swayne1908
220
20LP
Tnd
ndnd
nd16
16LP
Tnd
VD
24nd
Doran1906
120
21LP
T10
VD
40nd
Evans1899
120
20LP
T7
ndnd
ndEx
acou
stosa
ndRo
sati
1993
13nd
lt26
ndnd
NG
40(8)pretermgt
32(5)
nd
Burton
etal1989
8
nd13
LPT
18VD
40nd
nd15
LPT
14Fetald
emise
15weeks
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5nd
ndnd
Rella
etal1980
110
12LP
Tnd
VD
27Neonatald
eath
Case Reports in Obstetrics and Gynecology 7Ta
ble1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)Pelosietal1995
113
15LP
S6
CS39
ndPelissie
r-Ko
morek
etal2012
110
13LP
T22
VD
352280
g
Mollicae
tal1996
188ndash17
10ndash19
LPT
gt10
CS(17)V
D(1)
ndgt7(18)gt
2500
g(17)lt
2500
g(1)
Febo
etal1997
3nd
12ndash19
LPT
NG
CS(2)abortio
n(1)
37-38
nd
Bonito
etal2007
5nd
9ndash15
LPT
35ndash145
CS(2)VD(3)
382
9+minus083
3200ndash4
072g
Vazqu
ezCa
macho
etal2009
17
16LP
T62
VD
4099
Makar
etal1989
112
17LP
T13500
gCS
38993950
gHorno
Liria
1962
116
16LP
Tnd
VD
403600
gAlanise
tal2008
17
12LP
T30
VD
382330
g
Ardizzone1955
27
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
88
LPT
ndMisc
arria
geat9weeks
2424
LPT
ndFetald
emise
at25
weeks
88
LPT
ndMisc
arria
geat8weeks
1616
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at14
weeks
2020
LPT
ndnd
ndnd
1616
LPT
ndnd
ndnd
2020
LPT
ndnd
ndnd
2020
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at13
weeks
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at13
weeks
1212
LPT
ndnd
ndnd
1616
LPT
ndFetald
emise
at17
weeks
88
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at12
weeks
1212
LPT
ndnd
ndnd
8 Case Reports in Obstetrics and Gynecology
Table1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)
Cozzi1967
16
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
nd16
LPT
ndVD
38nd
nd8
LPT
ndVD
40nd
nd12
LPT
ndVD
38nd
nd8
LPT
ndVD
40nd
nd16
LPT
ndVD
40nd
nd20
LPT
ndVD
36nd
nd8
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd16
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
Rochetetal1964
14nd
ndLP
T10
ndnd
ndSciann
ameo
etal
1996
120
20LP
T4
ndnd
nd
ndnot
determ
inedC
Scesarean
section
VDvaginaldeliveryLP
TlaparotomyLP
Slap
aroscopyV
AGvaginalsurgery
Case Reports in Obstetrics and Gynecology 9
Italiana di Medicina Perinatale SIMP) Naples (Italy) 19ndash21January 2017
Conflicts of Interest
The authors declare that there are no conflicts of interest
References
[1] S G Vitale A Tropea D Rossetti M Carnelli and A CiancildquoManagement of uterine leiomyomas in pregnancy review ofliteraturerdquo Updates in Surgery vol 65 no 3 pp 179ndash182 2013
[2] S K Sunkara M Khairy T El-Toukhy Y Khalaf and ACoomarasamy ldquoThe effect of intramural fibroids without uter-ine cavity involvement on the outcome of IVF treatment asystematic review and meta-analysisrdquo Human Reproductionvol 25 no 2 pp 418ndash429 2010
[3] V Lozza A Pieralli S Corioni M Longinotti and C PennaldquoMultiple laparotomic myomectomy during pregnancy a casereportrdquo Archives of Gynecology and Obstetrics vol 284 no 3pp 613ndash616 2011
[4] L Domenici V Di Donato M L Gasparri F Lecce J Caccettaand P B Panici ldquoLaparotomic myomectomy in the 16th weekof pregnancy a case reportrdquo Case Reports in Obstetrics andGynecology 5 pages 2014
[5] D E Lolis S N KalantaridouGMakrydimas et al ldquoSuccessfulmyomectomy during pregnancyrdquoHuman Reproduction vol 18no 8 pp 1699ndash1702 2003
[6] S De Carolis G Fatigante S Ferrazzani et al ldquoUterinemyomectomy in pregnant womenrdquo Fetal Diagnosis and Ther-apy vol 16 no 2 pp 116ndash119 2001
[7] N Bhatla B B Dash A Kriplani and N Agarwal ldquoMyomec-tomy during pregnancy a feasible optionrdquo Journal of Obstetricsand Gynaecology Research vol 35 no 1 pp 173ndash175 2009
[8] A Cagnacci D Pirillo S Malmusi S Arangino C Alessan-drini and A Volpe ldquoEarly outcome of myomectomy by laparo-tomy minilaparotomy and laparoscopically assisted minila-parotomy A randomized prospective studyrdquoHuman Reproduc-tion vol 18 no 12 pp 2590ndash2594 2003
[9] F Parazzini S Cipriani G Bulfoni et al ldquoCentiles of weightat term birth according to maternal nationality in a northernItalian regionrdquo Italian Journal of Gynaecology and Obstetricsvol 28 no 2 pp 52ndash56 2016
[10] S P Michalas F V Oreopoulou and J S PapageorgiouldquoMyomectomy during pregnancy and caesarean sectionrdquoHuman Reproduction vol 10 no 7 pp 1869ndash1870 1995
[11] E Danzer W Holzgreve C Batukan P Miny S Tercanli and IHoesli ldquoMyomectomy during the first trimester associated withfetal limb anomalies and hydrocephalus in a twin pregnancyrdquoPrenatal Diagnosis vol 21 no 10 pp 848ndash851 2001
[12] J G Joo J Inovay M Silhavy and Z Papp ldquoSuccessfulenucleation of a necrotizing fibroid causing oligohydramniosand fetal postural deformity in the 25th week of gestation Acase reportrdquo Journal of Reproductive Medicine vol 46 no 10pp 923ndash925 2001
[13] C Celik A Acar N Cicek K Gezginc and C Akyurek ldquoCanmyomectomy be performed during pregnancyrdquo Gynecologicand Obstetric Investigation vol 53 no 2 pp 79ndash83 2002
[14] U Hasbargen A Strauss M Summerer-Moustaki et alldquoMyomectomy as a pregnancy-preserving option in the care-fully selected patientrdquo Fetal Diagnosis and Therapy vol 17 no2 pp 101ndash103 2002
[15] C Umezurike and P Feyi-Waboso ldquoSuccessful myomectomyduring pregnancy a case reportrdquo Reproductive Health vol 2no 1 2005
[16] F Usifo R Macrae R Sharma I O Opemuyi and BOnwuzurike ldquoSuccessful myomectomy in early second trimes-ter of pregnancyrdquo Journal of Obstetrics and Gynaecology vol 27no 2 pp 196ndash197 2007
[17] F S Suwandinata S E Gruessner C O Omwandho and H RTinneberg ldquoPregnancy-preserving myomectomy preliminaryreport on a new surgical techniquerdquo European Journal ofContraception and Reproductive Health Care vol 13 no 3 pp323ndash326 2008 Erratum in European Journal of Contraceptionand Reproductive Health Care vol 13 no 4 article 438 2008
[18] G K Leite H A Korkes T Viana Ade A Pitorri G Kenj andN Sass ldquoMyomectomy in the second trimester of pregnancycase reportrdquo Revista Brasileira De Ginecologia E Obstetricia vol32 no 4 pp 198ndash201 2010
[19] P Isabu J Eigbefoh F Okogbo S Okunsanya and R EifediyildquoMyomectomy during second trimester pregnancy a casereportrdquo The Nigerian Postgraduate Medical Journal vol 17 no4 pp 324ndash326 2010
[20] K Leach L Khatain and K Tocce ldquoFirst trimester myomec-tomy as an alternative to termination of pregnancy in a womanwith a symptomatic uterine leiomyoma a case reportrdquo Journalof Medical Case Reports vol 5 article 571 2011
[21] S Doerga-Bachasingh V Karsdorp G Yo R Van Der Weidenand M Van Hooff ldquoSuccessful myomectomy of a bleedingmyoma in a twin pregnancyrdquo JRSM Short Reports vol 3 no 2article 13 2012
[22] P Jhalta S G Negi andV Sharma ldquoSuccessful myomectomy inearly pregnancy for a large asymptomatic uterine myoma casereportrdquo Pan African Medical Journal vol 13 no 24 article 228Article ID 228 2016
[23] C Kosmidis G Pantos C Efthimiadis I Gkoutziomitrou EGeorgakoudi and G Anthimidis ldquoLaparoscopic excision of apedunculated uterine leiomyoma in torsion as a cause of acuteabdomen at 10 weeks of pregnancyrdquo American Journal of CaseReports vol 16 pp 505ndash508 2015
[24] C Saccardi S Visentin M Noventa E Cosmi P Litta and SGizzo ldquoUncertainties about laparoscopic myomectomy duringpregnancy a lack of evidence or an inherited misconceptionA critical literature review starting from a peculiar caserdquoMinimally Invasive Therapy and Allied Technologies vol 24 no4 pp 189ndash194 2015
[25] M Obara Y Hatakeyama and Y Shimizu ldquoVaginal myomec-tomy for semipedunculated cervical myoma during pregnancyrdquoAmerican Journal of Perinatology Reports vol 4 no 1 pp 37ndash402014
[26] A Currie E Bradley M McEwen N Al-Shabibi and P DWillson ldquoLaparoscopic approach to fibroid torsion presentingas an acute abdomen in pregnancyrdquo Journal of the Society ofLaparoendoscopic Surgeons vol 17 no 4 pp 665ndash667 2013
[27] F Kobayashi E Kondoh J Hamanishi Y Kawamura KTatsumi and I Konishi ldquoPyomayoma during pregnancy a casereport and review of the literaturerdquo Journal of Obstetrics andGynaecology Research vol 39 no 1 pp 383ndash389 2013
[28] A MacCio C Madeddu P Kotsonis et al ldquoThree cases oflaparoscopic myomectomy performed during pregnancy for
10 Case Reports in Obstetrics and Gynecology
pedunculated uterine myomasrdquo Archives of Gynecology andObstetrics vol 286 no 5 pp 1209ndash1214 2012
[29] M Shafiee M Nor Azlin and D Arifuddin ldquoA successfulantenatal myomectomyrdquo Malaysian Family Physician vol 31no 7(2-3) pp 42ndash45 2012
[30] M Ardovino I Ardovino M A Castaldi A Monteverde NColacurci and L Cobellis ldquoLaparoscopic myomectomy of asubserous pedunculated fibroid at 14 weeks of pregnancy a casereportrdquo Journal of Medical Case Reports vol 5 article 545 2011
[31] A Muller Vranjes S Sijanovic D Vidosavljevic Z Kasac andK Abicic Zuljevic ldquoSurgical treatment of large smooth muscletumor of uncertain malignant potential during pregnancyrdquoMedicinski Glasnik Journal vol 8 no 2 pp 290ndash292 2011
[32] C E Son J S Choi J H Lee S W Jeon J W Bae and S SSeo ldquoA case of laparoscopic myomectomy performed duringpregnancy for subserosal uterine myomardquo Journal of Obstetricsand Gynaecology vol 31 no 2 pp 180ndash181 2011
[33] M Kasum ldquoHemoperitoneum caused by a bleeding myoma inpregnancyrdquo Acta Clinica Croatica vol 49 no 2 pp 197ndash2002010
[34] F Fanfani C Rossitto A Fagotti P Rosati V Gallotta andG Scambia ldquoLaparoscopic myomectomy at 25 weeks of preg-nancy case reportrdquo Journal of Minimally Invasive Gynecologyvol 17 no 1 pp 91ndash93 2010
[35] A S Adeyemi S E Akinola and A I Isawumi ldquoAntepartummyomectomywith a live term deliverymdasha case reportrdquoNigerianJournal of Clinical Practice vol 10 no 4 pp 346ndash348 2007
[36] J E N Okonkwo and G O Udigwe ldquoMyomectomy in preg-nancyrdquo Journal of Obstetrics and Gynaecology vol 27 no 6 pp628ndash630 2007
[37] L Dracea and D Codreanu ldquoVaginal birth after extensivemyomectomy during pregnancy in a 39-year-old nulliparouswomanrdquo Journal of Obstetrics and Gynaecology vol 26 no 4pp 374ndash375 2006
[38] L Melgrati A Damiani G Franzoni M Marziali and FSesti ldquoIsobaric (gasless) laparoscopic myomectomy duringpregnancyrdquo Journal of Minimally Invasive Gynecology vol 12no 4 pp 379ndash381 2005
[39] L Sentilhes F Sergent E Verspyck A Gravier H Roman andL Marpeau ldquoLaparoscopic myomectomy during pregnancyresulting in septic necrosis of the myometriumrdquo BJOG AnInternational Journal of Obstetrics and Gynaecology vol 110 no9 pp 876ndash878 2003
[40] J Donnez C Pirard M Smets R Polet C Feger and JSquifflet ldquoUnusual growth of a myoma during pregnancyrdquoFertility and Sterility vol 78 no 3 pp 632ndash633 2002
[41] HWilliamson ldquoEnucleation during the seventh lunarmonth ofpregnancy of a uterine fibro-myomardquo Proceedings of the RoyalSociety of Medicine vol 1 pp 73ndash78 1908
[42] J Stewart ldquoEnucleation of fibro-myoma of uterus duringpregnancyrdquo British Medical Journal vol 1 no 2358 pp 548ndash549 1906
[43] A C Wittich E R Salminen M K Yancey and G RMarkenson ldquoMyomectomy during early pregnancyrdquo MilitaryMedicine vol 165 no 2 pp 162ndash164 2000
[44] M Majid G Q Khan and L MWei ldquoInevitable myomectomyin pregnancyrdquo Journal of Obstetrics and Gynaecology vol 17 no4 pp 377ndash378 1997
[45] A C Algara A G Rodrıguez A C Vazquez et al ldquoLaparo-scopic approach for fibroid removal at 18 weeks of pregnancyrdquoSurgical Technology International vol 27 pp 195ndash197 2015
[46] C Lockyer ldquoMultiple myomectomy in the sixth month ofpregnancy labour at termrdquo Proceedings of the Royal Society ofMedicine vol 7 pp 221ndash225 1914
[47] C A von Hoffmann ldquoAbdominal myomectomy during preg-nancyrdquoCalifornia State Journal ofMedicine vol 9 no 5 pp 197ndash200 1911
[48] H R Andrews ldquoMyomectomy during pregnancyrdquo Proceedingsof the Royal Society of Medicine vol 3 pp 164ndash166 1910
[49] WC Swayne ldquoAbdominal myomectomy during pregnancyrdquoProceedings of the Royal Society of Medicine vol 1 pp 129ndash1321908
[50] A Doran ldquoMyomectomy during pregnancy and labour at termin an elderly primipara with notes on similar casesrdquo BritishMedical Journal vol 2 no 2395 pp 1446ndash1447 1906
[51] H M Evans ldquoA case of myomectomy for subperitoneal myomacomplicating pregnancyrdquo British Medical Journal vol 2 no2033 p 1673 1899
[52] C Exacoustos and P Rosati ldquoUltrasound diagnosis of uterinemyomas and complications in pregnancyrdquoObstetrics and Gyne-cology vol 82 no 1 pp 97ndash101 1993
[53] C A Burton D A Grimes and C M March ldquoSurgicalmanagement of leiomyomata during pregnancyrdquoObstetrics andGynecology vol 74 no 5 pp 707ndash709 1989
[54] R Rella E Bonfadini Bossi and D Fagnani ldquoMyomectomy inpregnancy Description of an interesting clinical caserdquoMinervaGinecologica vol 32 no 4 pp 267ndash269 1980
[55] M A Pelosi M A Pelosi III and S Giblin ldquoLaparoscopicremoval of a 1500-g symptomatic myoma during the secondtrimester of pregnancyrdquo American Association of GynecologicLaparoscopists vol 2 no 4 pp 457ndash462 1995
[56] A Pelissier-Komorek J Hamm S Bonneau E Derniaux CHoeffel-Fornes and O Graesslin ldquoMyoma and pregnancywhen medical treatment is not sufficientrdquo Journal de Gynecolo-gie Obstetrique et Biologie de la Reproduction vol 41 no 3 pp307ndash310 2012
[57] G Mollica L Pittini E Minganti G Perri and F PansinildquoElective uterine myomectomy in pregnant womenrdquo Clinicaland Experimental Obstetrics and Gynecology vol 23 no 3 pp168ndash172 1996
[58] G Febo M Tessarolo L Leo S Arduino T Wierdis and LLanza ldquoSurgical management of leiomyomata in pregnancyrdquoClinical and ExperimentalObstetrics andGynecology vol 24 no2 pp 76ndash78 1997
[59] M Bonito L Gulemı R Basili and D Roselli ldquoMyomectomyduring the first and second trimester of pregnancyrdquoClinical andExperimental Obstetrics and Gynecology vol 34 no 3 pp 149ndash150 2007
[60] E E Vazquez Camacho E Cabrera Carranco and R GSanchez Herrera ldquoPedunculated twisted myoma and preg-nancy Case reportrdquoGinecologia y Obstetricia de Mexico vol 77no 9 pp 441ndash444 2009
[61] A P Makar E A Schatteman I B Vergote and E DesmedtldquoMyomectomy during pregnancy uncommon case reportrdquoActa Chirurgica Belgica vol 89 no 4 pp 212ndash214 1989
[62] R Horno Liria ldquoMyomectomy and pregnancyrdquo Rev Esp ObstetGinecol vol 19 pp 214ndash218 1962
[63] M C Alanis A Mitra and N Koklanaris ldquoPreoperativemagnetic resonance imaging and antepartummyomectomy of agiant pedunculated leiomyomardquoObstetrics and Gynecology vol111 no 2 part 2 pp 577ndash579 2008
Case Reports in Obstetrics and Gynecology 11
[64] G Ardizzone ldquoClinical and statistical considerations of 27cases of myomectomy in pregnancyrdquo Rivista di Ostetricia eGinecologia vol 10 no 12 pp 848ndash860 1955
[65] M Cozzi ldquoMyomectomy in pregnancyrdquo Quaderni di ClinicaOstetrica e Ginecologica vol 22 no 3 pp 171ndash180 1967
[66] Y Rochet M Cognat D Dargent and E Pollosson ldquoOnmyomectomy during pregnance (apropos of 14 observations)rdquoBulletin de la Federation des Societes de Gynecologie etDobstetrique de Langue Francaise vol 16 pp 462ndash463 1964
[67] F Sciannameo G Madami C Madami et al ldquoTorsion ofuterine fibroma associated with inguinal incarcerated hernia inpregnancy Case reportrdquo Minerva Ginecologica vol 48 no 11pp 501ndash504 1996
Submit your manuscripts athttpswwwhindawicom
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Diabetes ResearchJournal of
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
Case Reports in Obstetrics and Gynecology 3
1855 records identiedthrough database searching
1611 records aer duplicates were removed
40 full-text articles excludedReasons for exclusion31 linguistic reason9 not retrievable aer international librarian search
104 full-text articlesassessed for eligibility
63 studies included
1611 records screened 1508 records excluded
Iden
tica
tion
Scre
enin
gEl
igib
ility
Inclu
sion
Figure 2 Study selection process
records retrieved through database searches Both reviewersrecommended studies for the full-text review The screenof full-text articles recommended by at least one reviewerwas done independently by the same two reviewers andassessed for inclusion in the systematic review Disagree-ments between reviewers were resolved by consensus For allfull-text manuscripts reference lists were analyzed in orderto find additional eligible studies
4 Results
Theelectronic database search provided a total of 1855 resultsAfter duplicate exclusion there were 1611 citations left Ofthese 1508 were not relevant to the review based on titleand abstract screening 103 studies were considered for full-text assessment of which 40 were excluded for the followingreasons we could not translate 31 articles while nine paperscould not be retrieved even after international librariansearch
Overall 63 [3ndash6 10ndash67] articles were incorporated forfurther assessment The study selection process is shown inFigure 2 The main characteristics of the selected studies areincluded in Table 1
5 Discussion
Our review included 197 women undergoing myomectomyduring pregnancy The procedure was successful in 184women while in the remaining 13 cases a miscarriage or fetaldemise happened after the myomectomy
In 14 cases a laparoscopic approach was chosen in onecase there was a vaginal surgery while all the other casesfor which the surgical information was available underwentlaparotomy These data confirm that the most used surgicalintervention for myomas during pregnancy is the laparotomyroute
Maternal outcomes were favorable after myomectomywith only two episodes of hemoperitoneum [33 67] one uter-ine abscess [39] and only one woman requiring perioperativeblood transfusion [61]
Moreover the analysis of all reports was limited by twofactors (1) the heterogeneity of diagnostic information aswell as descriptive data connected to operation and pathologyexamination which did not allow clear categorization of thepathology preoperatively and postoperatively and (2) thelarge amount of missing or unreported data
6 Conclusion
Myomectomy is a feasible procedure if performed duringpregnancy Candidates need to be chosen carefully amongthose with symptomatic myomas since abdominal surgeryduring pregnancy can be associated with an increased riskfor the development of the great obstetrical syndromesespecially preterm labor and delivery
Disclosure
This paper has been presented in part at the 19th NationalCongress of the Italian Society of Perinatal Medicine (Societa
4 Case Reports in Obstetrics and Gynecology
Table1Ch
aracteris
ticso
fthe
relevant
studies
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)
DeC
arolisetal
2001
18
nd13
LPT
8CS
39883150
gnd
23LP
T40
CS38
882670
gnd
19LP
T14
VD
36893080
gnd
17LP
T21
CS38
893060
gnd
19LP
T15
Fetald
emise
at19
weeks
nd20
LPT
6VD
41992970
gnd
19LP
T12
CS39
793180
gnd
8LP
T9
CS40
993300
gnd
12LP
T8
CS38
9102780g
nd17
LPT
24CS
38993900
gnd
15LP
T10
CS40
8103170g
nd17
LPT
13CS
399103100g
nd6
LPT
15nd
ndnd
nd20
LPT
8CS
399102860g
nd10
LPT
16CS
409103500g
nd16
LPT
10CS
399103930g
nd13
LPT
14CS
39993180
gnd
7LP
T15
CS38
910
-2550g
Dom
enicietal
2014
116
16LP
T20
CS38
89-3
250g
Michalase
tal
1995
114
15LP
T20
CS39
2800
g
Danzere
tal2001
112
12LP
T10
CS37
9103235g
9102810g
Lozzae
tal2011
112
16LP
T18
CS36
992280
gJooetal2001
18
25LP
T12
CS40
3600
g
Celik
etal2002
5
nd22
LPT
13CS
386+minus11
103200g
nd18
LPT
10CS
386+minus11
93400
gnd
20LP
T12
CS386+minus11
10360
0gnd
16LP
T15
CS386+minus11
83100
gnd
13LP
T20
CS386+minus11
92800
gHasbargen
etal
2002
118
18LP
T15
CS36
892495
g
Umezurikea
ndFeyi-W
aboso2005
119
19LP
T32
VD
388103500g
Usifoetal2007
113
13LP
T17
CS38
3990
gSuwandinataetal
2009
1nd
18LP
Tnd
CS37
892950
g
Case Reports in Obstetrics and Gynecology 5
Table1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)Bh
atlaetal2009
18
19LP
T28
VD
382740
gLeite
etal2009
11sttrim
ester
17LP
T10
CS39
9103315g
Isabuetal2010
114
14LP
Tnd
CS37
2700
gLeachetal2011
111
11LP
T14
CS40
994356
gDoerga-
Bachasingh
etal
2012
19
10LP
T15
CS37
nd
Jhaltaetal2016
113
13LP
T16
VD
39810300
0gKo
smidisetal
2015
110
10LP
S8
ndnd
nd
Saccardi
etal2015
19
15LP
S24
CS41
4460
g72
Obara
etal2014
16
13VA
G6
VD
402775
gCu
rrieetal2013
111
11LP
S8
ndnd
ndKo
bayashietal
2013
121
21LP
T8
CS37
2730
g
MacCioetal2012
38
19LP
S11
CS39
3150
g20
20LP
S10
VD
403310g
2020
LPS
ndCS
393050
gShafiee
etal2012
115
21LP
S15
CS38
ndArdovinoetal
2011
114
14LP
S6
VD
403216g
MullerV
ranjes
etal
114
18LP
T35
CS33
1010
1750g
728
Sonetal2011
118
18LP
S9
VD
393740
gKa
sum
2010
115
15LP
T9
VD
38nd
Fanfanietal2010
125
25LP
S9
VD
402950
gAd
eyem
ietal
2007
119
19LP
T30
VD
397103500g
Okonk
woand
Udigw
e2007
119
24LP
Tnd
CSnd
nd
Draceaa
ndCod
reanu2006
112
13LP
T24
VD
ndnd
Melgratietal2005
124
24LP
S7
VD
3999
6 Case Reports in Obstetrics and GynecologyTa
ble1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)Sentilh
esetal
2003
117
17LP
S5
CS37
3530
g
Lolis
etal2003
13
nd16
LPT
ndCS
373340
gnd
15LP
Tnd
CS39
3600
gnd
19LP
Tnd
CS37
2970
gnd
16LP
Tnd
CS36
3000
gnd
15LP
Tnd
Fetald
emise
at15
weeks
nd15
LPT
ndCS
372740
gnd
16LP
Tnd
CS38
3180
gnd
16LP
Tnd
CS39
3515g
nd16
LPT
ndCS
393190
gnd
19LP
Tnd
CS38
2920
gnd
17LP
Tnd
CS38
3520
gnd
16LP
Tnd
CS38
3000
gnd
15LP
Tnd
CS29
1606
g
Don
neze
tal2002
1Be
fore
pregnancy
25LP
T22
CS35
2280
g
Williamson
1908
122
22LP
T32
VD
23Neonatald
eath
Stew
art1906
120
20LP
T24
VD
40nd
Wittichetal2000
112
15LP
T20
CS37
993275
gMajid
etal1997
117
18LP
T24
Fetald
emise
19weeks
Algarae
tal2015
118
18LP
S7
VD
24nd
Lockyer1914
121
21LP
Tnd
VD
402300
g
vonHoff
mann1911
316
16LP
Tnd
VD
403630
g22
25LP
Tnd
Fetald
emise
at25
weeks
1415
LPT
ndVD
40nd
And
rews1910
1Be
fore
pregnancy
9LP
Tnd
VD
40nd
Swayne1908
220
20LP
Tnd
ndnd
nd16
16LP
Tnd
VD
24nd
Doran1906
120
21LP
T10
VD
40nd
Evans1899
120
20LP
T7
ndnd
ndEx
acou
stosa
ndRo
sati
1993
13nd
lt26
ndnd
NG
40(8)pretermgt
32(5)
nd
Burton
etal1989
8
nd13
LPT
18VD
40nd
nd15
LPT
14Fetald
emise
15weeks
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5nd
ndnd
Rella
etal1980
110
12LP
Tnd
VD
27Neonatald
eath
Case Reports in Obstetrics and Gynecology 7Ta
ble1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)Pelosietal1995
113
15LP
S6
CS39
ndPelissie
r-Ko
morek
etal2012
110
13LP
T22
VD
352280
g
Mollicae
tal1996
188ndash17
10ndash19
LPT
gt10
CS(17)V
D(1)
ndgt7(18)gt
2500
g(17)lt
2500
g(1)
Febo
etal1997
3nd
12ndash19
LPT
NG
CS(2)abortio
n(1)
37-38
nd
Bonito
etal2007
5nd
9ndash15
LPT
35ndash145
CS(2)VD(3)
382
9+minus083
3200ndash4
072g
Vazqu
ezCa
macho
etal2009
17
16LP
T62
VD
4099
Makar
etal1989
112
17LP
T13500
gCS
38993950
gHorno
Liria
1962
116
16LP
Tnd
VD
403600
gAlanise
tal2008
17
12LP
T30
VD
382330
g
Ardizzone1955
27
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
88
LPT
ndMisc
arria
geat9weeks
2424
LPT
ndFetald
emise
at25
weeks
88
LPT
ndMisc
arria
geat8weeks
1616
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at14
weeks
2020
LPT
ndnd
ndnd
1616
LPT
ndnd
ndnd
2020
LPT
ndnd
ndnd
2020
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at13
weeks
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at13
weeks
1212
LPT
ndnd
ndnd
1616
LPT
ndFetald
emise
at17
weeks
88
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at12
weeks
1212
LPT
ndnd
ndnd
8 Case Reports in Obstetrics and Gynecology
Table1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)
Cozzi1967
16
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
nd16
LPT
ndVD
38nd
nd8
LPT
ndVD
40nd
nd12
LPT
ndVD
38nd
nd8
LPT
ndVD
40nd
nd16
LPT
ndVD
40nd
nd20
LPT
ndVD
36nd
nd8
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd16
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
Rochetetal1964
14nd
ndLP
T10
ndnd
ndSciann
ameo
etal
1996
120
20LP
T4
ndnd
nd
ndnot
determ
inedC
Scesarean
section
VDvaginaldeliveryLP
TlaparotomyLP
Slap
aroscopyV
AGvaginalsurgery
Case Reports in Obstetrics and Gynecology 9
Italiana di Medicina Perinatale SIMP) Naples (Italy) 19ndash21January 2017
Conflicts of Interest
The authors declare that there are no conflicts of interest
References
[1] S G Vitale A Tropea D Rossetti M Carnelli and A CiancildquoManagement of uterine leiomyomas in pregnancy review ofliteraturerdquo Updates in Surgery vol 65 no 3 pp 179ndash182 2013
[2] S K Sunkara M Khairy T El-Toukhy Y Khalaf and ACoomarasamy ldquoThe effect of intramural fibroids without uter-ine cavity involvement on the outcome of IVF treatment asystematic review and meta-analysisrdquo Human Reproductionvol 25 no 2 pp 418ndash429 2010
[3] V Lozza A Pieralli S Corioni M Longinotti and C PennaldquoMultiple laparotomic myomectomy during pregnancy a casereportrdquo Archives of Gynecology and Obstetrics vol 284 no 3pp 613ndash616 2011
[4] L Domenici V Di Donato M L Gasparri F Lecce J Caccettaand P B Panici ldquoLaparotomic myomectomy in the 16th weekof pregnancy a case reportrdquo Case Reports in Obstetrics andGynecology 5 pages 2014
[5] D E Lolis S N KalantaridouGMakrydimas et al ldquoSuccessfulmyomectomy during pregnancyrdquoHuman Reproduction vol 18no 8 pp 1699ndash1702 2003
[6] S De Carolis G Fatigante S Ferrazzani et al ldquoUterinemyomectomy in pregnant womenrdquo Fetal Diagnosis and Ther-apy vol 16 no 2 pp 116ndash119 2001
[7] N Bhatla B B Dash A Kriplani and N Agarwal ldquoMyomec-tomy during pregnancy a feasible optionrdquo Journal of Obstetricsand Gynaecology Research vol 35 no 1 pp 173ndash175 2009
[8] A Cagnacci D Pirillo S Malmusi S Arangino C Alessan-drini and A Volpe ldquoEarly outcome of myomectomy by laparo-tomy minilaparotomy and laparoscopically assisted minila-parotomy A randomized prospective studyrdquoHuman Reproduc-tion vol 18 no 12 pp 2590ndash2594 2003
[9] F Parazzini S Cipriani G Bulfoni et al ldquoCentiles of weightat term birth according to maternal nationality in a northernItalian regionrdquo Italian Journal of Gynaecology and Obstetricsvol 28 no 2 pp 52ndash56 2016
[10] S P Michalas F V Oreopoulou and J S PapageorgiouldquoMyomectomy during pregnancy and caesarean sectionrdquoHuman Reproduction vol 10 no 7 pp 1869ndash1870 1995
[11] E Danzer W Holzgreve C Batukan P Miny S Tercanli and IHoesli ldquoMyomectomy during the first trimester associated withfetal limb anomalies and hydrocephalus in a twin pregnancyrdquoPrenatal Diagnosis vol 21 no 10 pp 848ndash851 2001
[12] J G Joo J Inovay M Silhavy and Z Papp ldquoSuccessfulenucleation of a necrotizing fibroid causing oligohydramniosand fetal postural deformity in the 25th week of gestation Acase reportrdquo Journal of Reproductive Medicine vol 46 no 10pp 923ndash925 2001
[13] C Celik A Acar N Cicek K Gezginc and C Akyurek ldquoCanmyomectomy be performed during pregnancyrdquo Gynecologicand Obstetric Investigation vol 53 no 2 pp 79ndash83 2002
[14] U Hasbargen A Strauss M Summerer-Moustaki et alldquoMyomectomy as a pregnancy-preserving option in the care-fully selected patientrdquo Fetal Diagnosis and Therapy vol 17 no2 pp 101ndash103 2002
[15] C Umezurike and P Feyi-Waboso ldquoSuccessful myomectomyduring pregnancy a case reportrdquo Reproductive Health vol 2no 1 2005
[16] F Usifo R Macrae R Sharma I O Opemuyi and BOnwuzurike ldquoSuccessful myomectomy in early second trimes-ter of pregnancyrdquo Journal of Obstetrics and Gynaecology vol 27no 2 pp 196ndash197 2007
[17] F S Suwandinata S E Gruessner C O Omwandho and H RTinneberg ldquoPregnancy-preserving myomectomy preliminaryreport on a new surgical techniquerdquo European Journal ofContraception and Reproductive Health Care vol 13 no 3 pp323ndash326 2008 Erratum in European Journal of Contraceptionand Reproductive Health Care vol 13 no 4 article 438 2008
[18] G K Leite H A Korkes T Viana Ade A Pitorri G Kenj andN Sass ldquoMyomectomy in the second trimester of pregnancycase reportrdquo Revista Brasileira De Ginecologia E Obstetricia vol32 no 4 pp 198ndash201 2010
[19] P Isabu J Eigbefoh F Okogbo S Okunsanya and R EifediyildquoMyomectomy during second trimester pregnancy a casereportrdquo The Nigerian Postgraduate Medical Journal vol 17 no4 pp 324ndash326 2010
[20] K Leach L Khatain and K Tocce ldquoFirst trimester myomec-tomy as an alternative to termination of pregnancy in a womanwith a symptomatic uterine leiomyoma a case reportrdquo Journalof Medical Case Reports vol 5 article 571 2011
[21] S Doerga-Bachasingh V Karsdorp G Yo R Van Der Weidenand M Van Hooff ldquoSuccessful myomectomy of a bleedingmyoma in a twin pregnancyrdquo JRSM Short Reports vol 3 no 2article 13 2012
[22] P Jhalta S G Negi andV Sharma ldquoSuccessful myomectomy inearly pregnancy for a large asymptomatic uterine myoma casereportrdquo Pan African Medical Journal vol 13 no 24 article 228Article ID 228 2016
[23] C Kosmidis G Pantos C Efthimiadis I Gkoutziomitrou EGeorgakoudi and G Anthimidis ldquoLaparoscopic excision of apedunculated uterine leiomyoma in torsion as a cause of acuteabdomen at 10 weeks of pregnancyrdquo American Journal of CaseReports vol 16 pp 505ndash508 2015
[24] C Saccardi S Visentin M Noventa E Cosmi P Litta and SGizzo ldquoUncertainties about laparoscopic myomectomy duringpregnancy a lack of evidence or an inherited misconceptionA critical literature review starting from a peculiar caserdquoMinimally Invasive Therapy and Allied Technologies vol 24 no4 pp 189ndash194 2015
[25] M Obara Y Hatakeyama and Y Shimizu ldquoVaginal myomec-tomy for semipedunculated cervical myoma during pregnancyrdquoAmerican Journal of Perinatology Reports vol 4 no 1 pp 37ndash402014
[26] A Currie E Bradley M McEwen N Al-Shabibi and P DWillson ldquoLaparoscopic approach to fibroid torsion presentingas an acute abdomen in pregnancyrdquo Journal of the Society ofLaparoendoscopic Surgeons vol 17 no 4 pp 665ndash667 2013
[27] F Kobayashi E Kondoh J Hamanishi Y Kawamura KTatsumi and I Konishi ldquoPyomayoma during pregnancy a casereport and review of the literaturerdquo Journal of Obstetrics andGynaecology Research vol 39 no 1 pp 383ndash389 2013
[28] A MacCio C Madeddu P Kotsonis et al ldquoThree cases oflaparoscopic myomectomy performed during pregnancy for
10 Case Reports in Obstetrics and Gynecology
pedunculated uterine myomasrdquo Archives of Gynecology andObstetrics vol 286 no 5 pp 1209ndash1214 2012
[29] M Shafiee M Nor Azlin and D Arifuddin ldquoA successfulantenatal myomectomyrdquo Malaysian Family Physician vol 31no 7(2-3) pp 42ndash45 2012
[30] M Ardovino I Ardovino M A Castaldi A Monteverde NColacurci and L Cobellis ldquoLaparoscopic myomectomy of asubserous pedunculated fibroid at 14 weeks of pregnancy a casereportrdquo Journal of Medical Case Reports vol 5 article 545 2011
[31] A Muller Vranjes S Sijanovic D Vidosavljevic Z Kasac andK Abicic Zuljevic ldquoSurgical treatment of large smooth muscletumor of uncertain malignant potential during pregnancyrdquoMedicinski Glasnik Journal vol 8 no 2 pp 290ndash292 2011
[32] C E Son J S Choi J H Lee S W Jeon J W Bae and S SSeo ldquoA case of laparoscopic myomectomy performed duringpregnancy for subserosal uterine myomardquo Journal of Obstetricsand Gynaecology vol 31 no 2 pp 180ndash181 2011
[33] M Kasum ldquoHemoperitoneum caused by a bleeding myoma inpregnancyrdquo Acta Clinica Croatica vol 49 no 2 pp 197ndash2002010
[34] F Fanfani C Rossitto A Fagotti P Rosati V Gallotta andG Scambia ldquoLaparoscopic myomectomy at 25 weeks of preg-nancy case reportrdquo Journal of Minimally Invasive Gynecologyvol 17 no 1 pp 91ndash93 2010
[35] A S Adeyemi S E Akinola and A I Isawumi ldquoAntepartummyomectomywith a live term deliverymdasha case reportrdquoNigerianJournal of Clinical Practice vol 10 no 4 pp 346ndash348 2007
[36] J E N Okonkwo and G O Udigwe ldquoMyomectomy in preg-nancyrdquo Journal of Obstetrics and Gynaecology vol 27 no 6 pp628ndash630 2007
[37] L Dracea and D Codreanu ldquoVaginal birth after extensivemyomectomy during pregnancy in a 39-year-old nulliparouswomanrdquo Journal of Obstetrics and Gynaecology vol 26 no 4pp 374ndash375 2006
[38] L Melgrati A Damiani G Franzoni M Marziali and FSesti ldquoIsobaric (gasless) laparoscopic myomectomy duringpregnancyrdquo Journal of Minimally Invasive Gynecology vol 12no 4 pp 379ndash381 2005
[39] L Sentilhes F Sergent E Verspyck A Gravier H Roman andL Marpeau ldquoLaparoscopic myomectomy during pregnancyresulting in septic necrosis of the myometriumrdquo BJOG AnInternational Journal of Obstetrics and Gynaecology vol 110 no9 pp 876ndash878 2003
[40] J Donnez C Pirard M Smets R Polet C Feger and JSquifflet ldquoUnusual growth of a myoma during pregnancyrdquoFertility and Sterility vol 78 no 3 pp 632ndash633 2002
[41] HWilliamson ldquoEnucleation during the seventh lunarmonth ofpregnancy of a uterine fibro-myomardquo Proceedings of the RoyalSociety of Medicine vol 1 pp 73ndash78 1908
[42] J Stewart ldquoEnucleation of fibro-myoma of uterus duringpregnancyrdquo British Medical Journal vol 1 no 2358 pp 548ndash549 1906
[43] A C Wittich E R Salminen M K Yancey and G RMarkenson ldquoMyomectomy during early pregnancyrdquo MilitaryMedicine vol 165 no 2 pp 162ndash164 2000
[44] M Majid G Q Khan and L MWei ldquoInevitable myomectomyin pregnancyrdquo Journal of Obstetrics and Gynaecology vol 17 no4 pp 377ndash378 1997
[45] A C Algara A G Rodrıguez A C Vazquez et al ldquoLaparo-scopic approach for fibroid removal at 18 weeks of pregnancyrdquoSurgical Technology International vol 27 pp 195ndash197 2015
[46] C Lockyer ldquoMultiple myomectomy in the sixth month ofpregnancy labour at termrdquo Proceedings of the Royal Society ofMedicine vol 7 pp 221ndash225 1914
[47] C A von Hoffmann ldquoAbdominal myomectomy during preg-nancyrdquoCalifornia State Journal ofMedicine vol 9 no 5 pp 197ndash200 1911
[48] H R Andrews ldquoMyomectomy during pregnancyrdquo Proceedingsof the Royal Society of Medicine vol 3 pp 164ndash166 1910
[49] WC Swayne ldquoAbdominal myomectomy during pregnancyrdquoProceedings of the Royal Society of Medicine vol 1 pp 129ndash1321908
[50] A Doran ldquoMyomectomy during pregnancy and labour at termin an elderly primipara with notes on similar casesrdquo BritishMedical Journal vol 2 no 2395 pp 1446ndash1447 1906
[51] H M Evans ldquoA case of myomectomy for subperitoneal myomacomplicating pregnancyrdquo British Medical Journal vol 2 no2033 p 1673 1899
[52] C Exacoustos and P Rosati ldquoUltrasound diagnosis of uterinemyomas and complications in pregnancyrdquoObstetrics and Gyne-cology vol 82 no 1 pp 97ndash101 1993
[53] C A Burton D A Grimes and C M March ldquoSurgicalmanagement of leiomyomata during pregnancyrdquoObstetrics andGynecology vol 74 no 5 pp 707ndash709 1989
[54] R Rella E Bonfadini Bossi and D Fagnani ldquoMyomectomy inpregnancy Description of an interesting clinical caserdquoMinervaGinecologica vol 32 no 4 pp 267ndash269 1980
[55] M A Pelosi M A Pelosi III and S Giblin ldquoLaparoscopicremoval of a 1500-g symptomatic myoma during the secondtrimester of pregnancyrdquo American Association of GynecologicLaparoscopists vol 2 no 4 pp 457ndash462 1995
[56] A Pelissier-Komorek J Hamm S Bonneau E Derniaux CHoeffel-Fornes and O Graesslin ldquoMyoma and pregnancywhen medical treatment is not sufficientrdquo Journal de Gynecolo-gie Obstetrique et Biologie de la Reproduction vol 41 no 3 pp307ndash310 2012
[57] G Mollica L Pittini E Minganti G Perri and F PansinildquoElective uterine myomectomy in pregnant womenrdquo Clinicaland Experimental Obstetrics and Gynecology vol 23 no 3 pp168ndash172 1996
[58] G Febo M Tessarolo L Leo S Arduino T Wierdis and LLanza ldquoSurgical management of leiomyomata in pregnancyrdquoClinical and ExperimentalObstetrics andGynecology vol 24 no2 pp 76ndash78 1997
[59] M Bonito L Gulemı R Basili and D Roselli ldquoMyomectomyduring the first and second trimester of pregnancyrdquoClinical andExperimental Obstetrics and Gynecology vol 34 no 3 pp 149ndash150 2007
[60] E E Vazquez Camacho E Cabrera Carranco and R GSanchez Herrera ldquoPedunculated twisted myoma and preg-nancy Case reportrdquoGinecologia y Obstetricia de Mexico vol 77no 9 pp 441ndash444 2009
[61] A P Makar E A Schatteman I B Vergote and E DesmedtldquoMyomectomy during pregnancy uncommon case reportrdquoActa Chirurgica Belgica vol 89 no 4 pp 212ndash214 1989
[62] R Horno Liria ldquoMyomectomy and pregnancyrdquo Rev Esp ObstetGinecol vol 19 pp 214ndash218 1962
[63] M C Alanis A Mitra and N Koklanaris ldquoPreoperativemagnetic resonance imaging and antepartummyomectomy of agiant pedunculated leiomyomardquoObstetrics and Gynecology vol111 no 2 part 2 pp 577ndash579 2008
Case Reports in Obstetrics and Gynecology 11
[64] G Ardizzone ldquoClinical and statistical considerations of 27cases of myomectomy in pregnancyrdquo Rivista di Ostetricia eGinecologia vol 10 no 12 pp 848ndash860 1955
[65] M Cozzi ldquoMyomectomy in pregnancyrdquo Quaderni di ClinicaOstetrica e Ginecologica vol 22 no 3 pp 171ndash180 1967
[66] Y Rochet M Cognat D Dargent and E Pollosson ldquoOnmyomectomy during pregnance (apropos of 14 observations)rdquoBulletin de la Federation des Societes de Gynecologie etDobstetrique de Langue Francaise vol 16 pp 462ndash463 1964
[67] F Sciannameo G Madami C Madami et al ldquoTorsion ofuterine fibroma associated with inguinal incarcerated hernia inpregnancy Case reportrdquo Minerva Ginecologica vol 48 no 11pp 501ndash504 1996
Submit your manuscripts athttpswwwhindawicom
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
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Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
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Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
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Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
4 Case Reports in Obstetrics and Gynecology
Table1Ch
aracteris
ticso
fthe
relevant
studies
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)
DeC
arolisetal
2001
18
nd13
LPT
8CS
39883150
gnd
23LP
T40
CS38
882670
gnd
19LP
T14
VD
36893080
gnd
17LP
T21
CS38
893060
gnd
19LP
T15
Fetald
emise
at19
weeks
nd20
LPT
6VD
41992970
gnd
19LP
T12
CS39
793180
gnd
8LP
T9
CS40
993300
gnd
12LP
T8
CS38
9102780g
nd17
LPT
24CS
38993900
gnd
15LP
T10
CS40
8103170g
nd17
LPT
13CS
399103100g
nd6
LPT
15nd
ndnd
nd20
LPT
8CS
399102860g
nd10
LPT
16CS
409103500g
nd16
LPT
10CS
399103930g
nd13
LPT
14CS
39993180
gnd
7LP
T15
CS38
910
-2550g
Dom
enicietal
2014
116
16LP
T20
CS38
89-3
250g
Michalase
tal
1995
114
15LP
T20
CS39
2800
g
Danzere
tal2001
112
12LP
T10
CS37
9103235g
9102810g
Lozzae
tal2011
112
16LP
T18
CS36
992280
gJooetal2001
18
25LP
T12
CS40
3600
g
Celik
etal2002
5
nd22
LPT
13CS
386+minus11
103200g
nd18
LPT
10CS
386+minus11
93400
gnd
20LP
T12
CS386+minus11
10360
0gnd
16LP
T15
CS386+minus11
83100
gnd
13LP
T20
CS386+minus11
92800
gHasbargen
etal
2002
118
18LP
T15
CS36
892495
g
Umezurikea
ndFeyi-W
aboso2005
119
19LP
T32
VD
388103500g
Usifoetal2007
113
13LP
T17
CS38
3990
gSuwandinataetal
2009
1nd
18LP
Tnd
CS37
892950
g
Case Reports in Obstetrics and Gynecology 5
Table1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)Bh
atlaetal2009
18
19LP
T28
VD
382740
gLeite
etal2009
11sttrim
ester
17LP
T10
CS39
9103315g
Isabuetal2010
114
14LP
Tnd
CS37
2700
gLeachetal2011
111
11LP
T14
CS40
994356
gDoerga-
Bachasingh
etal
2012
19
10LP
T15
CS37
nd
Jhaltaetal2016
113
13LP
T16
VD
39810300
0gKo
smidisetal
2015
110
10LP
S8
ndnd
nd
Saccardi
etal2015
19
15LP
S24
CS41
4460
g72
Obara
etal2014
16
13VA
G6
VD
402775
gCu
rrieetal2013
111
11LP
S8
ndnd
ndKo
bayashietal
2013
121
21LP
T8
CS37
2730
g
MacCioetal2012
38
19LP
S11
CS39
3150
g20
20LP
S10
VD
403310g
2020
LPS
ndCS
393050
gShafiee
etal2012
115
21LP
S15
CS38
ndArdovinoetal
2011
114
14LP
S6
VD
403216g
MullerV
ranjes
etal
114
18LP
T35
CS33
1010
1750g
728
Sonetal2011
118
18LP
S9
VD
393740
gKa
sum
2010
115
15LP
T9
VD
38nd
Fanfanietal2010
125
25LP
S9
VD
402950
gAd
eyem
ietal
2007
119
19LP
T30
VD
397103500g
Okonk
woand
Udigw
e2007
119
24LP
Tnd
CSnd
nd
Draceaa
ndCod
reanu2006
112
13LP
T24
VD
ndnd
Melgratietal2005
124
24LP
S7
VD
3999
6 Case Reports in Obstetrics and GynecologyTa
ble1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)Sentilh
esetal
2003
117
17LP
S5
CS37
3530
g
Lolis
etal2003
13
nd16
LPT
ndCS
373340
gnd
15LP
Tnd
CS39
3600
gnd
19LP
Tnd
CS37
2970
gnd
16LP
Tnd
CS36
3000
gnd
15LP
Tnd
Fetald
emise
at15
weeks
nd15
LPT
ndCS
372740
gnd
16LP
Tnd
CS38
3180
gnd
16LP
Tnd
CS39
3515g
nd16
LPT
ndCS
393190
gnd
19LP
Tnd
CS38
2920
gnd
17LP
Tnd
CS38
3520
gnd
16LP
Tnd
CS38
3000
gnd
15LP
Tnd
CS29
1606
g
Don
neze
tal2002
1Be
fore
pregnancy
25LP
T22
CS35
2280
g
Williamson
1908
122
22LP
T32
VD
23Neonatald
eath
Stew
art1906
120
20LP
T24
VD
40nd
Wittichetal2000
112
15LP
T20
CS37
993275
gMajid
etal1997
117
18LP
T24
Fetald
emise
19weeks
Algarae
tal2015
118
18LP
S7
VD
24nd
Lockyer1914
121
21LP
Tnd
VD
402300
g
vonHoff
mann1911
316
16LP
Tnd
VD
403630
g22
25LP
Tnd
Fetald
emise
at25
weeks
1415
LPT
ndVD
40nd
And
rews1910
1Be
fore
pregnancy
9LP
Tnd
VD
40nd
Swayne1908
220
20LP
Tnd
ndnd
nd16
16LP
Tnd
VD
24nd
Doran1906
120
21LP
T10
VD
40nd
Evans1899
120
20LP
T7
ndnd
ndEx
acou
stosa
ndRo
sati
1993
13nd
lt26
ndnd
NG
40(8)pretermgt
32(5)
nd
Burton
etal1989
8
nd13
LPT
18VD
40nd
nd15
LPT
14Fetald
emise
15weeks
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5nd
ndnd
Rella
etal1980
110
12LP
Tnd
VD
27Neonatald
eath
Case Reports in Obstetrics and Gynecology 7Ta
ble1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)Pelosietal1995
113
15LP
S6
CS39
ndPelissie
r-Ko
morek
etal2012
110
13LP
T22
VD
352280
g
Mollicae
tal1996
188ndash17
10ndash19
LPT
gt10
CS(17)V
D(1)
ndgt7(18)gt
2500
g(17)lt
2500
g(1)
Febo
etal1997
3nd
12ndash19
LPT
NG
CS(2)abortio
n(1)
37-38
nd
Bonito
etal2007
5nd
9ndash15
LPT
35ndash145
CS(2)VD(3)
382
9+minus083
3200ndash4
072g
Vazqu
ezCa
macho
etal2009
17
16LP
T62
VD
4099
Makar
etal1989
112
17LP
T13500
gCS
38993950
gHorno
Liria
1962
116
16LP
Tnd
VD
403600
gAlanise
tal2008
17
12LP
T30
VD
382330
g
Ardizzone1955
27
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
88
LPT
ndMisc
arria
geat9weeks
2424
LPT
ndFetald
emise
at25
weeks
88
LPT
ndMisc
arria
geat8weeks
1616
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at14
weeks
2020
LPT
ndnd
ndnd
1616
LPT
ndnd
ndnd
2020
LPT
ndnd
ndnd
2020
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at13
weeks
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at13
weeks
1212
LPT
ndnd
ndnd
1616
LPT
ndFetald
emise
at17
weeks
88
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at12
weeks
1212
LPT
ndnd
ndnd
8 Case Reports in Obstetrics and Gynecology
Table1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)
Cozzi1967
16
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
nd16
LPT
ndVD
38nd
nd8
LPT
ndVD
40nd
nd12
LPT
ndVD
38nd
nd8
LPT
ndVD
40nd
nd16
LPT
ndVD
40nd
nd20
LPT
ndVD
36nd
nd8
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd16
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
Rochetetal1964
14nd
ndLP
T10
ndnd
ndSciann
ameo
etal
1996
120
20LP
T4
ndnd
nd
ndnot
determ
inedC
Scesarean
section
VDvaginaldeliveryLP
TlaparotomyLP
Slap
aroscopyV
AGvaginalsurgery
Case Reports in Obstetrics and Gynecology 9
Italiana di Medicina Perinatale SIMP) Naples (Italy) 19ndash21January 2017
Conflicts of Interest
The authors declare that there are no conflicts of interest
References
[1] S G Vitale A Tropea D Rossetti M Carnelli and A CiancildquoManagement of uterine leiomyomas in pregnancy review ofliteraturerdquo Updates in Surgery vol 65 no 3 pp 179ndash182 2013
[2] S K Sunkara M Khairy T El-Toukhy Y Khalaf and ACoomarasamy ldquoThe effect of intramural fibroids without uter-ine cavity involvement on the outcome of IVF treatment asystematic review and meta-analysisrdquo Human Reproductionvol 25 no 2 pp 418ndash429 2010
[3] V Lozza A Pieralli S Corioni M Longinotti and C PennaldquoMultiple laparotomic myomectomy during pregnancy a casereportrdquo Archives of Gynecology and Obstetrics vol 284 no 3pp 613ndash616 2011
[4] L Domenici V Di Donato M L Gasparri F Lecce J Caccettaand P B Panici ldquoLaparotomic myomectomy in the 16th weekof pregnancy a case reportrdquo Case Reports in Obstetrics andGynecology 5 pages 2014
[5] D E Lolis S N KalantaridouGMakrydimas et al ldquoSuccessfulmyomectomy during pregnancyrdquoHuman Reproduction vol 18no 8 pp 1699ndash1702 2003
[6] S De Carolis G Fatigante S Ferrazzani et al ldquoUterinemyomectomy in pregnant womenrdquo Fetal Diagnosis and Ther-apy vol 16 no 2 pp 116ndash119 2001
[7] N Bhatla B B Dash A Kriplani and N Agarwal ldquoMyomec-tomy during pregnancy a feasible optionrdquo Journal of Obstetricsand Gynaecology Research vol 35 no 1 pp 173ndash175 2009
[8] A Cagnacci D Pirillo S Malmusi S Arangino C Alessan-drini and A Volpe ldquoEarly outcome of myomectomy by laparo-tomy minilaparotomy and laparoscopically assisted minila-parotomy A randomized prospective studyrdquoHuman Reproduc-tion vol 18 no 12 pp 2590ndash2594 2003
[9] F Parazzini S Cipriani G Bulfoni et al ldquoCentiles of weightat term birth according to maternal nationality in a northernItalian regionrdquo Italian Journal of Gynaecology and Obstetricsvol 28 no 2 pp 52ndash56 2016
[10] S P Michalas F V Oreopoulou and J S PapageorgiouldquoMyomectomy during pregnancy and caesarean sectionrdquoHuman Reproduction vol 10 no 7 pp 1869ndash1870 1995
[11] E Danzer W Holzgreve C Batukan P Miny S Tercanli and IHoesli ldquoMyomectomy during the first trimester associated withfetal limb anomalies and hydrocephalus in a twin pregnancyrdquoPrenatal Diagnosis vol 21 no 10 pp 848ndash851 2001
[12] J G Joo J Inovay M Silhavy and Z Papp ldquoSuccessfulenucleation of a necrotizing fibroid causing oligohydramniosand fetal postural deformity in the 25th week of gestation Acase reportrdquo Journal of Reproductive Medicine vol 46 no 10pp 923ndash925 2001
[13] C Celik A Acar N Cicek K Gezginc and C Akyurek ldquoCanmyomectomy be performed during pregnancyrdquo Gynecologicand Obstetric Investigation vol 53 no 2 pp 79ndash83 2002
[14] U Hasbargen A Strauss M Summerer-Moustaki et alldquoMyomectomy as a pregnancy-preserving option in the care-fully selected patientrdquo Fetal Diagnosis and Therapy vol 17 no2 pp 101ndash103 2002
[15] C Umezurike and P Feyi-Waboso ldquoSuccessful myomectomyduring pregnancy a case reportrdquo Reproductive Health vol 2no 1 2005
[16] F Usifo R Macrae R Sharma I O Opemuyi and BOnwuzurike ldquoSuccessful myomectomy in early second trimes-ter of pregnancyrdquo Journal of Obstetrics and Gynaecology vol 27no 2 pp 196ndash197 2007
[17] F S Suwandinata S E Gruessner C O Omwandho and H RTinneberg ldquoPregnancy-preserving myomectomy preliminaryreport on a new surgical techniquerdquo European Journal ofContraception and Reproductive Health Care vol 13 no 3 pp323ndash326 2008 Erratum in European Journal of Contraceptionand Reproductive Health Care vol 13 no 4 article 438 2008
[18] G K Leite H A Korkes T Viana Ade A Pitorri G Kenj andN Sass ldquoMyomectomy in the second trimester of pregnancycase reportrdquo Revista Brasileira De Ginecologia E Obstetricia vol32 no 4 pp 198ndash201 2010
[19] P Isabu J Eigbefoh F Okogbo S Okunsanya and R EifediyildquoMyomectomy during second trimester pregnancy a casereportrdquo The Nigerian Postgraduate Medical Journal vol 17 no4 pp 324ndash326 2010
[20] K Leach L Khatain and K Tocce ldquoFirst trimester myomec-tomy as an alternative to termination of pregnancy in a womanwith a symptomatic uterine leiomyoma a case reportrdquo Journalof Medical Case Reports vol 5 article 571 2011
[21] S Doerga-Bachasingh V Karsdorp G Yo R Van Der Weidenand M Van Hooff ldquoSuccessful myomectomy of a bleedingmyoma in a twin pregnancyrdquo JRSM Short Reports vol 3 no 2article 13 2012
[22] P Jhalta S G Negi andV Sharma ldquoSuccessful myomectomy inearly pregnancy for a large asymptomatic uterine myoma casereportrdquo Pan African Medical Journal vol 13 no 24 article 228Article ID 228 2016
[23] C Kosmidis G Pantos C Efthimiadis I Gkoutziomitrou EGeorgakoudi and G Anthimidis ldquoLaparoscopic excision of apedunculated uterine leiomyoma in torsion as a cause of acuteabdomen at 10 weeks of pregnancyrdquo American Journal of CaseReports vol 16 pp 505ndash508 2015
[24] C Saccardi S Visentin M Noventa E Cosmi P Litta and SGizzo ldquoUncertainties about laparoscopic myomectomy duringpregnancy a lack of evidence or an inherited misconceptionA critical literature review starting from a peculiar caserdquoMinimally Invasive Therapy and Allied Technologies vol 24 no4 pp 189ndash194 2015
[25] M Obara Y Hatakeyama and Y Shimizu ldquoVaginal myomec-tomy for semipedunculated cervical myoma during pregnancyrdquoAmerican Journal of Perinatology Reports vol 4 no 1 pp 37ndash402014
[26] A Currie E Bradley M McEwen N Al-Shabibi and P DWillson ldquoLaparoscopic approach to fibroid torsion presentingas an acute abdomen in pregnancyrdquo Journal of the Society ofLaparoendoscopic Surgeons vol 17 no 4 pp 665ndash667 2013
[27] F Kobayashi E Kondoh J Hamanishi Y Kawamura KTatsumi and I Konishi ldquoPyomayoma during pregnancy a casereport and review of the literaturerdquo Journal of Obstetrics andGynaecology Research vol 39 no 1 pp 383ndash389 2013
[28] A MacCio C Madeddu P Kotsonis et al ldquoThree cases oflaparoscopic myomectomy performed during pregnancy for
10 Case Reports in Obstetrics and Gynecology
pedunculated uterine myomasrdquo Archives of Gynecology andObstetrics vol 286 no 5 pp 1209ndash1214 2012
[29] M Shafiee M Nor Azlin and D Arifuddin ldquoA successfulantenatal myomectomyrdquo Malaysian Family Physician vol 31no 7(2-3) pp 42ndash45 2012
[30] M Ardovino I Ardovino M A Castaldi A Monteverde NColacurci and L Cobellis ldquoLaparoscopic myomectomy of asubserous pedunculated fibroid at 14 weeks of pregnancy a casereportrdquo Journal of Medical Case Reports vol 5 article 545 2011
[31] A Muller Vranjes S Sijanovic D Vidosavljevic Z Kasac andK Abicic Zuljevic ldquoSurgical treatment of large smooth muscletumor of uncertain malignant potential during pregnancyrdquoMedicinski Glasnik Journal vol 8 no 2 pp 290ndash292 2011
[32] C E Son J S Choi J H Lee S W Jeon J W Bae and S SSeo ldquoA case of laparoscopic myomectomy performed duringpregnancy for subserosal uterine myomardquo Journal of Obstetricsand Gynaecology vol 31 no 2 pp 180ndash181 2011
[33] M Kasum ldquoHemoperitoneum caused by a bleeding myoma inpregnancyrdquo Acta Clinica Croatica vol 49 no 2 pp 197ndash2002010
[34] F Fanfani C Rossitto A Fagotti P Rosati V Gallotta andG Scambia ldquoLaparoscopic myomectomy at 25 weeks of preg-nancy case reportrdquo Journal of Minimally Invasive Gynecologyvol 17 no 1 pp 91ndash93 2010
[35] A S Adeyemi S E Akinola and A I Isawumi ldquoAntepartummyomectomywith a live term deliverymdasha case reportrdquoNigerianJournal of Clinical Practice vol 10 no 4 pp 346ndash348 2007
[36] J E N Okonkwo and G O Udigwe ldquoMyomectomy in preg-nancyrdquo Journal of Obstetrics and Gynaecology vol 27 no 6 pp628ndash630 2007
[37] L Dracea and D Codreanu ldquoVaginal birth after extensivemyomectomy during pregnancy in a 39-year-old nulliparouswomanrdquo Journal of Obstetrics and Gynaecology vol 26 no 4pp 374ndash375 2006
[38] L Melgrati A Damiani G Franzoni M Marziali and FSesti ldquoIsobaric (gasless) laparoscopic myomectomy duringpregnancyrdquo Journal of Minimally Invasive Gynecology vol 12no 4 pp 379ndash381 2005
[39] L Sentilhes F Sergent E Verspyck A Gravier H Roman andL Marpeau ldquoLaparoscopic myomectomy during pregnancyresulting in septic necrosis of the myometriumrdquo BJOG AnInternational Journal of Obstetrics and Gynaecology vol 110 no9 pp 876ndash878 2003
[40] J Donnez C Pirard M Smets R Polet C Feger and JSquifflet ldquoUnusual growth of a myoma during pregnancyrdquoFertility and Sterility vol 78 no 3 pp 632ndash633 2002
[41] HWilliamson ldquoEnucleation during the seventh lunarmonth ofpregnancy of a uterine fibro-myomardquo Proceedings of the RoyalSociety of Medicine vol 1 pp 73ndash78 1908
[42] J Stewart ldquoEnucleation of fibro-myoma of uterus duringpregnancyrdquo British Medical Journal vol 1 no 2358 pp 548ndash549 1906
[43] A C Wittich E R Salminen M K Yancey and G RMarkenson ldquoMyomectomy during early pregnancyrdquo MilitaryMedicine vol 165 no 2 pp 162ndash164 2000
[44] M Majid G Q Khan and L MWei ldquoInevitable myomectomyin pregnancyrdquo Journal of Obstetrics and Gynaecology vol 17 no4 pp 377ndash378 1997
[45] A C Algara A G Rodrıguez A C Vazquez et al ldquoLaparo-scopic approach for fibroid removal at 18 weeks of pregnancyrdquoSurgical Technology International vol 27 pp 195ndash197 2015
[46] C Lockyer ldquoMultiple myomectomy in the sixth month ofpregnancy labour at termrdquo Proceedings of the Royal Society ofMedicine vol 7 pp 221ndash225 1914
[47] C A von Hoffmann ldquoAbdominal myomectomy during preg-nancyrdquoCalifornia State Journal ofMedicine vol 9 no 5 pp 197ndash200 1911
[48] H R Andrews ldquoMyomectomy during pregnancyrdquo Proceedingsof the Royal Society of Medicine vol 3 pp 164ndash166 1910
[49] WC Swayne ldquoAbdominal myomectomy during pregnancyrdquoProceedings of the Royal Society of Medicine vol 1 pp 129ndash1321908
[50] A Doran ldquoMyomectomy during pregnancy and labour at termin an elderly primipara with notes on similar casesrdquo BritishMedical Journal vol 2 no 2395 pp 1446ndash1447 1906
[51] H M Evans ldquoA case of myomectomy for subperitoneal myomacomplicating pregnancyrdquo British Medical Journal vol 2 no2033 p 1673 1899
[52] C Exacoustos and P Rosati ldquoUltrasound diagnosis of uterinemyomas and complications in pregnancyrdquoObstetrics and Gyne-cology vol 82 no 1 pp 97ndash101 1993
[53] C A Burton D A Grimes and C M March ldquoSurgicalmanagement of leiomyomata during pregnancyrdquoObstetrics andGynecology vol 74 no 5 pp 707ndash709 1989
[54] R Rella E Bonfadini Bossi and D Fagnani ldquoMyomectomy inpregnancy Description of an interesting clinical caserdquoMinervaGinecologica vol 32 no 4 pp 267ndash269 1980
[55] M A Pelosi M A Pelosi III and S Giblin ldquoLaparoscopicremoval of a 1500-g symptomatic myoma during the secondtrimester of pregnancyrdquo American Association of GynecologicLaparoscopists vol 2 no 4 pp 457ndash462 1995
[56] A Pelissier-Komorek J Hamm S Bonneau E Derniaux CHoeffel-Fornes and O Graesslin ldquoMyoma and pregnancywhen medical treatment is not sufficientrdquo Journal de Gynecolo-gie Obstetrique et Biologie de la Reproduction vol 41 no 3 pp307ndash310 2012
[57] G Mollica L Pittini E Minganti G Perri and F PansinildquoElective uterine myomectomy in pregnant womenrdquo Clinicaland Experimental Obstetrics and Gynecology vol 23 no 3 pp168ndash172 1996
[58] G Febo M Tessarolo L Leo S Arduino T Wierdis and LLanza ldquoSurgical management of leiomyomata in pregnancyrdquoClinical and ExperimentalObstetrics andGynecology vol 24 no2 pp 76ndash78 1997
[59] M Bonito L Gulemı R Basili and D Roselli ldquoMyomectomyduring the first and second trimester of pregnancyrdquoClinical andExperimental Obstetrics and Gynecology vol 34 no 3 pp 149ndash150 2007
[60] E E Vazquez Camacho E Cabrera Carranco and R GSanchez Herrera ldquoPedunculated twisted myoma and preg-nancy Case reportrdquoGinecologia y Obstetricia de Mexico vol 77no 9 pp 441ndash444 2009
[61] A P Makar E A Schatteman I B Vergote and E DesmedtldquoMyomectomy during pregnancy uncommon case reportrdquoActa Chirurgica Belgica vol 89 no 4 pp 212ndash214 1989
[62] R Horno Liria ldquoMyomectomy and pregnancyrdquo Rev Esp ObstetGinecol vol 19 pp 214ndash218 1962
[63] M C Alanis A Mitra and N Koklanaris ldquoPreoperativemagnetic resonance imaging and antepartummyomectomy of agiant pedunculated leiomyomardquoObstetrics and Gynecology vol111 no 2 part 2 pp 577ndash579 2008
Case Reports in Obstetrics and Gynecology 11
[64] G Ardizzone ldquoClinical and statistical considerations of 27cases of myomectomy in pregnancyrdquo Rivista di Ostetricia eGinecologia vol 10 no 12 pp 848ndash860 1955
[65] M Cozzi ldquoMyomectomy in pregnancyrdquo Quaderni di ClinicaOstetrica e Ginecologica vol 22 no 3 pp 171ndash180 1967
[66] Y Rochet M Cognat D Dargent and E Pollosson ldquoOnmyomectomy during pregnance (apropos of 14 observations)rdquoBulletin de la Federation des Societes de Gynecologie etDobstetrique de Langue Francaise vol 16 pp 462ndash463 1964
[67] F Sciannameo G Madami C Madami et al ldquoTorsion ofuterine fibroma associated with inguinal incarcerated hernia inpregnancy Case reportrdquo Minerva Ginecologica vol 48 no 11pp 501ndash504 1996
Submit your manuscripts athttpswwwhindawicom
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Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
Case Reports in Obstetrics and Gynecology 5
Table1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)Bh
atlaetal2009
18
19LP
T28
VD
382740
gLeite
etal2009
11sttrim
ester
17LP
T10
CS39
9103315g
Isabuetal2010
114
14LP
Tnd
CS37
2700
gLeachetal2011
111
11LP
T14
CS40
994356
gDoerga-
Bachasingh
etal
2012
19
10LP
T15
CS37
nd
Jhaltaetal2016
113
13LP
T16
VD
39810300
0gKo
smidisetal
2015
110
10LP
S8
ndnd
nd
Saccardi
etal2015
19
15LP
S24
CS41
4460
g72
Obara
etal2014
16
13VA
G6
VD
402775
gCu
rrieetal2013
111
11LP
S8
ndnd
ndKo
bayashietal
2013
121
21LP
T8
CS37
2730
g
MacCioetal2012
38
19LP
S11
CS39
3150
g20
20LP
S10
VD
403310g
2020
LPS
ndCS
393050
gShafiee
etal2012
115
21LP
S15
CS38
ndArdovinoetal
2011
114
14LP
S6
VD
403216g
MullerV
ranjes
etal
114
18LP
T35
CS33
1010
1750g
728
Sonetal2011
118
18LP
S9
VD
393740
gKa
sum
2010
115
15LP
T9
VD
38nd
Fanfanietal2010
125
25LP
S9
VD
402950
gAd
eyem
ietal
2007
119
19LP
T30
VD
397103500g
Okonk
woand
Udigw
e2007
119
24LP
Tnd
CSnd
nd
Draceaa
ndCod
reanu2006
112
13LP
T24
VD
ndnd
Melgratietal2005
124
24LP
S7
VD
3999
6 Case Reports in Obstetrics and GynecologyTa
ble1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)Sentilh
esetal
2003
117
17LP
S5
CS37
3530
g
Lolis
etal2003
13
nd16
LPT
ndCS
373340
gnd
15LP
Tnd
CS39
3600
gnd
19LP
Tnd
CS37
2970
gnd
16LP
Tnd
CS36
3000
gnd
15LP
Tnd
Fetald
emise
at15
weeks
nd15
LPT
ndCS
372740
gnd
16LP
Tnd
CS38
3180
gnd
16LP
Tnd
CS39
3515g
nd16
LPT
ndCS
393190
gnd
19LP
Tnd
CS38
2920
gnd
17LP
Tnd
CS38
3520
gnd
16LP
Tnd
CS38
3000
gnd
15LP
Tnd
CS29
1606
g
Don
neze
tal2002
1Be
fore
pregnancy
25LP
T22
CS35
2280
g
Williamson
1908
122
22LP
T32
VD
23Neonatald
eath
Stew
art1906
120
20LP
T24
VD
40nd
Wittichetal2000
112
15LP
T20
CS37
993275
gMajid
etal1997
117
18LP
T24
Fetald
emise
19weeks
Algarae
tal2015
118
18LP
S7
VD
24nd
Lockyer1914
121
21LP
Tnd
VD
402300
g
vonHoff
mann1911
316
16LP
Tnd
VD
403630
g22
25LP
Tnd
Fetald
emise
at25
weeks
1415
LPT
ndVD
40nd
And
rews1910
1Be
fore
pregnancy
9LP
Tnd
VD
40nd
Swayne1908
220
20LP
Tnd
ndnd
nd16
16LP
Tnd
VD
24nd
Doran1906
120
21LP
T10
VD
40nd
Evans1899
120
20LP
T7
ndnd
ndEx
acou
stosa
ndRo
sati
1993
13nd
lt26
ndnd
NG
40(8)pretermgt
32(5)
nd
Burton
etal1989
8
nd13
LPT
18VD
40nd
nd15
LPT
14Fetald
emise
15weeks
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5nd
ndnd
Rella
etal1980
110
12LP
Tnd
VD
27Neonatald
eath
Case Reports in Obstetrics and Gynecology 7Ta
ble1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)Pelosietal1995
113
15LP
S6
CS39
ndPelissie
r-Ko
morek
etal2012
110
13LP
T22
VD
352280
g
Mollicae
tal1996
188ndash17
10ndash19
LPT
gt10
CS(17)V
D(1)
ndgt7(18)gt
2500
g(17)lt
2500
g(1)
Febo
etal1997
3nd
12ndash19
LPT
NG
CS(2)abortio
n(1)
37-38
nd
Bonito
etal2007
5nd
9ndash15
LPT
35ndash145
CS(2)VD(3)
382
9+minus083
3200ndash4
072g
Vazqu
ezCa
macho
etal2009
17
16LP
T62
VD
4099
Makar
etal1989
112
17LP
T13500
gCS
38993950
gHorno
Liria
1962
116
16LP
Tnd
VD
403600
gAlanise
tal2008
17
12LP
T30
VD
382330
g
Ardizzone1955
27
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
88
LPT
ndMisc
arria
geat9weeks
2424
LPT
ndFetald
emise
at25
weeks
88
LPT
ndMisc
arria
geat8weeks
1616
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at14
weeks
2020
LPT
ndnd
ndnd
1616
LPT
ndnd
ndnd
2020
LPT
ndnd
ndnd
2020
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at13
weeks
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at13
weeks
1212
LPT
ndnd
ndnd
1616
LPT
ndFetald
emise
at17
weeks
88
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at12
weeks
1212
LPT
ndnd
ndnd
8 Case Reports in Obstetrics and Gynecology
Table1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)
Cozzi1967
16
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
nd16
LPT
ndVD
38nd
nd8
LPT
ndVD
40nd
nd12
LPT
ndVD
38nd
nd8
LPT
ndVD
40nd
nd16
LPT
ndVD
40nd
nd20
LPT
ndVD
36nd
nd8
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd16
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
Rochetetal1964
14nd
ndLP
T10
ndnd
ndSciann
ameo
etal
1996
120
20LP
T4
ndnd
nd
ndnot
determ
inedC
Scesarean
section
VDvaginaldeliveryLP
TlaparotomyLP
Slap
aroscopyV
AGvaginalsurgery
Case Reports in Obstetrics and Gynecology 9
Italiana di Medicina Perinatale SIMP) Naples (Italy) 19ndash21January 2017
Conflicts of Interest
The authors declare that there are no conflicts of interest
References
[1] S G Vitale A Tropea D Rossetti M Carnelli and A CiancildquoManagement of uterine leiomyomas in pregnancy review ofliteraturerdquo Updates in Surgery vol 65 no 3 pp 179ndash182 2013
[2] S K Sunkara M Khairy T El-Toukhy Y Khalaf and ACoomarasamy ldquoThe effect of intramural fibroids without uter-ine cavity involvement on the outcome of IVF treatment asystematic review and meta-analysisrdquo Human Reproductionvol 25 no 2 pp 418ndash429 2010
[3] V Lozza A Pieralli S Corioni M Longinotti and C PennaldquoMultiple laparotomic myomectomy during pregnancy a casereportrdquo Archives of Gynecology and Obstetrics vol 284 no 3pp 613ndash616 2011
[4] L Domenici V Di Donato M L Gasparri F Lecce J Caccettaand P B Panici ldquoLaparotomic myomectomy in the 16th weekof pregnancy a case reportrdquo Case Reports in Obstetrics andGynecology 5 pages 2014
[5] D E Lolis S N KalantaridouGMakrydimas et al ldquoSuccessfulmyomectomy during pregnancyrdquoHuman Reproduction vol 18no 8 pp 1699ndash1702 2003
[6] S De Carolis G Fatigante S Ferrazzani et al ldquoUterinemyomectomy in pregnant womenrdquo Fetal Diagnosis and Ther-apy vol 16 no 2 pp 116ndash119 2001
[7] N Bhatla B B Dash A Kriplani and N Agarwal ldquoMyomec-tomy during pregnancy a feasible optionrdquo Journal of Obstetricsand Gynaecology Research vol 35 no 1 pp 173ndash175 2009
[8] A Cagnacci D Pirillo S Malmusi S Arangino C Alessan-drini and A Volpe ldquoEarly outcome of myomectomy by laparo-tomy minilaparotomy and laparoscopically assisted minila-parotomy A randomized prospective studyrdquoHuman Reproduc-tion vol 18 no 12 pp 2590ndash2594 2003
[9] F Parazzini S Cipriani G Bulfoni et al ldquoCentiles of weightat term birth according to maternal nationality in a northernItalian regionrdquo Italian Journal of Gynaecology and Obstetricsvol 28 no 2 pp 52ndash56 2016
[10] S P Michalas F V Oreopoulou and J S PapageorgiouldquoMyomectomy during pregnancy and caesarean sectionrdquoHuman Reproduction vol 10 no 7 pp 1869ndash1870 1995
[11] E Danzer W Holzgreve C Batukan P Miny S Tercanli and IHoesli ldquoMyomectomy during the first trimester associated withfetal limb anomalies and hydrocephalus in a twin pregnancyrdquoPrenatal Diagnosis vol 21 no 10 pp 848ndash851 2001
[12] J G Joo J Inovay M Silhavy and Z Papp ldquoSuccessfulenucleation of a necrotizing fibroid causing oligohydramniosand fetal postural deformity in the 25th week of gestation Acase reportrdquo Journal of Reproductive Medicine vol 46 no 10pp 923ndash925 2001
[13] C Celik A Acar N Cicek K Gezginc and C Akyurek ldquoCanmyomectomy be performed during pregnancyrdquo Gynecologicand Obstetric Investigation vol 53 no 2 pp 79ndash83 2002
[14] U Hasbargen A Strauss M Summerer-Moustaki et alldquoMyomectomy as a pregnancy-preserving option in the care-fully selected patientrdquo Fetal Diagnosis and Therapy vol 17 no2 pp 101ndash103 2002
[15] C Umezurike and P Feyi-Waboso ldquoSuccessful myomectomyduring pregnancy a case reportrdquo Reproductive Health vol 2no 1 2005
[16] F Usifo R Macrae R Sharma I O Opemuyi and BOnwuzurike ldquoSuccessful myomectomy in early second trimes-ter of pregnancyrdquo Journal of Obstetrics and Gynaecology vol 27no 2 pp 196ndash197 2007
[17] F S Suwandinata S E Gruessner C O Omwandho and H RTinneberg ldquoPregnancy-preserving myomectomy preliminaryreport on a new surgical techniquerdquo European Journal ofContraception and Reproductive Health Care vol 13 no 3 pp323ndash326 2008 Erratum in European Journal of Contraceptionand Reproductive Health Care vol 13 no 4 article 438 2008
[18] G K Leite H A Korkes T Viana Ade A Pitorri G Kenj andN Sass ldquoMyomectomy in the second trimester of pregnancycase reportrdquo Revista Brasileira De Ginecologia E Obstetricia vol32 no 4 pp 198ndash201 2010
[19] P Isabu J Eigbefoh F Okogbo S Okunsanya and R EifediyildquoMyomectomy during second trimester pregnancy a casereportrdquo The Nigerian Postgraduate Medical Journal vol 17 no4 pp 324ndash326 2010
[20] K Leach L Khatain and K Tocce ldquoFirst trimester myomec-tomy as an alternative to termination of pregnancy in a womanwith a symptomatic uterine leiomyoma a case reportrdquo Journalof Medical Case Reports vol 5 article 571 2011
[21] S Doerga-Bachasingh V Karsdorp G Yo R Van Der Weidenand M Van Hooff ldquoSuccessful myomectomy of a bleedingmyoma in a twin pregnancyrdquo JRSM Short Reports vol 3 no 2article 13 2012
[22] P Jhalta S G Negi andV Sharma ldquoSuccessful myomectomy inearly pregnancy for a large asymptomatic uterine myoma casereportrdquo Pan African Medical Journal vol 13 no 24 article 228Article ID 228 2016
[23] C Kosmidis G Pantos C Efthimiadis I Gkoutziomitrou EGeorgakoudi and G Anthimidis ldquoLaparoscopic excision of apedunculated uterine leiomyoma in torsion as a cause of acuteabdomen at 10 weeks of pregnancyrdquo American Journal of CaseReports vol 16 pp 505ndash508 2015
[24] C Saccardi S Visentin M Noventa E Cosmi P Litta and SGizzo ldquoUncertainties about laparoscopic myomectomy duringpregnancy a lack of evidence or an inherited misconceptionA critical literature review starting from a peculiar caserdquoMinimally Invasive Therapy and Allied Technologies vol 24 no4 pp 189ndash194 2015
[25] M Obara Y Hatakeyama and Y Shimizu ldquoVaginal myomec-tomy for semipedunculated cervical myoma during pregnancyrdquoAmerican Journal of Perinatology Reports vol 4 no 1 pp 37ndash402014
[26] A Currie E Bradley M McEwen N Al-Shabibi and P DWillson ldquoLaparoscopic approach to fibroid torsion presentingas an acute abdomen in pregnancyrdquo Journal of the Society ofLaparoendoscopic Surgeons vol 17 no 4 pp 665ndash667 2013
[27] F Kobayashi E Kondoh J Hamanishi Y Kawamura KTatsumi and I Konishi ldquoPyomayoma during pregnancy a casereport and review of the literaturerdquo Journal of Obstetrics andGynaecology Research vol 39 no 1 pp 383ndash389 2013
[28] A MacCio C Madeddu P Kotsonis et al ldquoThree cases oflaparoscopic myomectomy performed during pregnancy for
10 Case Reports in Obstetrics and Gynecology
pedunculated uterine myomasrdquo Archives of Gynecology andObstetrics vol 286 no 5 pp 1209ndash1214 2012
[29] M Shafiee M Nor Azlin and D Arifuddin ldquoA successfulantenatal myomectomyrdquo Malaysian Family Physician vol 31no 7(2-3) pp 42ndash45 2012
[30] M Ardovino I Ardovino M A Castaldi A Monteverde NColacurci and L Cobellis ldquoLaparoscopic myomectomy of asubserous pedunculated fibroid at 14 weeks of pregnancy a casereportrdquo Journal of Medical Case Reports vol 5 article 545 2011
[31] A Muller Vranjes S Sijanovic D Vidosavljevic Z Kasac andK Abicic Zuljevic ldquoSurgical treatment of large smooth muscletumor of uncertain malignant potential during pregnancyrdquoMedicinski Glasnik Journal vol 8 no 2 pp 290ndash292 2011
[32] C E Son J S Choi J H Lee S W Jeon J W Bae and S SSeo ldquoA case of laparoscopic myomectomy performed duringpregnancy for subserosal uterine myomardquo Journal of Obstetricsand Gynaecology vol 31 no 2 pp 180ndash181 2011
[33] M Kasum ldquoHemoperitoneum caused by a bleeding myoma inpregnancyrdquo Acta Clinica Croatica vol 49 no 2 pp 197ndash2002010
[34] F Fanfani C Rossitto A Fagotti P Rosati V Gallotta andG Scambia ldquoLaparoscopic myomectomy at 25 weeks of preg-nancy case reportrdquo Journal of Minimally Invasive Gynecologyvol 17 no 1 pp 91ndash93 2010
[35] A S Adeyemi S E Akinola and A I Isawumi ldquoAntepartummyomectomywith a live term deliverymdasha case reportrdquoNigerianJournal of Clinical Practice vol 10 no 4 pp 346ndash348 2007
[36] J E N Okonkwo and G O Udigwe ldquoMyomectomy in preg-nancyrdquo Journal of Obstetrics and Gynaecology vol 27 no 6 pp628ndash630 2007
[37] L Dracea and D Codreanu ldquoVaginal birth after extensivemyomectomy during pregnancy in a 39-year-old nulliparouswomanrdquo Journal of Obstetrics and Gynaecology vol 26 no 4pp 374ndash375 2006
[38] L Melgrati A Damiani G Franzoni M Marziali and FSesti ldquoIsobaric (gasless) laparoscopic myomectomy duringpregnancyrdquo Journal of Minimally Invasive Gynecology vol 12no 4 pp 379ndash381 2005
[39] L Sentilhes F Sergent E Verspyck A Gravier H Roman andL Marpeau ldquoLaparoscopic myomectomy during pregnancyresulting in septic necrosis of the myometriumrdquo BJOG AnInternational Journal of Obstetrics and Gynaecology vol 110 no9 pp 876ndash878 2003
[40] J Donnez C Pirard M Smets R Polet C Feger and JSquifflet ldquoUnusual growth of a myoma during pregnancyrdquoFertility and Sterility vol 78 no 3 pp 632ndash633 2002
[41] HWilliamson ldquoEnucleation during the seventh lunarmonth ofpregnancy of a uterine fibro-myomardquo Proceedings of the RoyalSociety of Medicine vol 1 pp 73ndash78 1908
[42] J Stewart ldquoEnucleation of fibro-myoma of uterus duringpregnancyrdquo British Medical Journal vol 1 no 2358 pp 548ndash549 1906
[43] A C Wittich E R Salminen M K Yancey and G RMarkenson ldquoMyomectomy during early pregnancyrdquo MilitaryMedicine vol 165 no 2 pp 162ndash164 2000
[44] M Majid G Q Khan and L MWei ldquoInevitable myomectomyin pregnancyrdquo Journal of Obstetrics and Gynaecology vol 17 no4 pp 377ndash378 1997
[45] A C Algara A G Rodrıguez A C Vazquez et al ldquoLaparo-scopic approach for fibroid removal at 18 weeks of pregnancyrdquoSurgical Technology International vol 27 pp 195ndash197 2015
[46] C Lockyer ldquoMultiple myomectomy in the sixth month ofpregnancy labour at termrdquo Proceedings of the Royal Society ofMedicine vol 7 pp 221ndash225 1914
[47] C A von Hoffmann ldquoAbdominal myomectomy during preg-nancyrdquoCalifornia State Journal ofMedicine vol 9 no 5 pp 197ndash200 1911
[48] H R Andrews ldquoMyomectomy during pregnancyrdquo Proceedingsof the Royal Society of Medicine vol 3 pp 164ndash166 1910
[49] WC Swayne ldquoAbdominal myomectomy during pregnancyrdquoProceedings of the Royal Society of Medicine vol 1 pp 129ndash1321908
[50] A Doran ldquoMyomectomy during pregnancy and labour at termin an elderly primipara with notes on similar casesrdquo BritishMedical Journal vol 2 no 2395 pp 1446ndash1447 1906
[51] H M Evans ldquoA case of myomectomy for subperitoneal myomacomplicating pregnancyrdquo British Medical Journal vol 2 no2033 p 1673 1899
[52] C Exacoustos and P Rosati ldquoUltrasound diagnosis of uterinemyomas and complications in pregnancyrdquoObstetrics and Gyne-cology vol 82 no 1 pp 97ndash101 1993
[53] C A Burton D A Grimes and C M March ldquoSurgicalmanagement of leiomyomata during pregnancyrdquoObstetrics andGynecology vol 74 no 5 pp 707ndash709 1989
[54] R Rella E Bonfadini Bossi and D Fagnani ldquoMyomectomy inpregnancy Description of an interesting clinical caserdquoMinervaGinecologica vol 32 no 4 pp 267ndash269 1980
[55] M A Pelosi M A Pelosi III and S Giblin ldquoLaparoscopicremoval of a 1500-g symptomatic myoma during the secondtrimester of pregnancyrdquo American Association of GynecologicLaparoscopists vol 2 no 4 pp 457ndash462 1995
[56] A Pelissier-Komorek J Hamm S Bonneau E Derniaux CHoeffel-Fornes and O Graesslin ldquoMyoma and pregnancywhen medical treatment is not sufficientrdquo Journal de Gynecolo-gie Obstetrique et Biologie de la Reproduction vol 41 no 3 pp307ndash310 2012
[57] G Mollica L Pittini E Minganti G Perri and F PansinildquoElective uterine myomectomy in pregnant womenrdquo Clinicaland Experimental Obstetrics and Gynecology vol 23 no 3 pp168ndash172 1996
[58] G Febo M Tessarolo L Leo S Arduino T Wierdis and LLanza ldquoSurgical management of leiomyomata in pregnancyrdquoClinical and ExperimentalObstetrics andGynecology vol 24 no2 pp 76ndash78 1997
[59] M Bonito L Gulemı R Basili and D Roselli ldquoMyomectomyduring the first and second trimester of pregnancyrdquoClinical andExperimental Obstetrics and Gynecology vol 34 no 3 pp 149ndash150 2007
[60] E E Vazquez Camacho E Cabrera Carranco and R GSanchez Herrera ldquoPedunculated twisted myoma and preg-nancy Case reportrdquoGinecologia y Obstetricia de Mexico vol 77no 9 pp 441ndash444 2009
[61] A P Makar E A Schatteman I B Vergote and E DesmedtldquoMyomectomy during pregnancy uncommon case reportrdquoActa Chirurgica Belgica vol 89 no 4 pp 212ndash214 1989
[62] R Horno Liria ldquoMyomectomy and pregnancyrdquo Rev Esp ObstetGinecol vol 19 pp 214ndash218 1962
[63] M C Alanis A Mitra and N Koklanaris ldquoPreoperativemagnetic resonance imaging and antepartummyomectomy of agiant pedunculated leiomyomardquoObstetrics and Gynecology vol111 no 2 part 2 pp 577ndash579 2008
Case Reports in Obstetrics and Gynecology 11
[64] G Ardizzone ldquoClinical and statistical considerations of 27cases of myomectomy in pregnancyrdquo Rivista di Ostetricia eGinecologia vol 10 no 12 pp 848ndash860 1955
[65] M Cozzi ldquoMyomectomy in pregnancyrdquo Quaderni di ClinicaOstetrica e Ginecologica vol 22 no 3 pp 171ndash180 1967
[66] Y Rochet M Cognat D Dargent and E Pollosson ldquoOnmyomectomy during pregnance (apropos of 14 observations)rdquoBulletin de la Federation des Societes de Gynecologie etDobstetrique de Langue Francaise vol 16 pp 462ndash463 1964
[67] F Sciannameo G Madami C Madami et al ldquoTorsion ofuterine fibroma associated with inguinal incarcerated hernia inpregnancy Case reportrdquo Minerva Ginecologica vol 48 no 11pp 501ndash504 1996
Submit your manuscripts athttpswwwhindawicom
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Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
6 Case Reports in Obstetrics and GynecologyTa
ble1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)Sentilh
esetal
2003
117
17LP
S5
CS37
3530
g
Lolis
etal2003
13
nd16
LPT
ndCS
373340
gnd
15LP
Tnd
CS39
3600
gnd
19LP
Tnd
CS37
2970
gnd
16LP
Tnd
CS36
3000
gnd
15LP
Tnd
Fetald
emise
at15
weeks
nd15
LPT
ndCS
372740
gnd
16LP
Tnd
CS38
3180
gnd
16LP
Tnd
CS39
3515g
nd16
LPT
ndCS
393190
gnd
19LP
Tnd
CS38
2920
gnd
17LP
Tnd
CS38
3520
gnd
16LP
Tnd
CS38
3000
gnd
15LP
Tnd
CS29
1606
g
Don
neze
tal2002
1Be
fore
pregnancy
25LP
T22
CS35
2280
g
Williamson
1908
122
22LP
T32
VD
23Neonatald
eath
Stew
art1906
120
20LP
T24
VD
40nd
Wittichetal2000
112
15LP
T20
CS37
993275
gMajid
etal1997
117
18LP
T24
Fetald
emise
19weeks
Algarae
tal2015
118
18LP
S7
VD
24nd
Lockyer1914
121
21LP
Tnd
VD
402300
g
vonHoff
mann1911
316
16LP
Tnd
VD
403630
g22
25LP
Tnd
Fetald
emise
at25
weeks
1415
LPT
ndVD
40nd
And
rews1910
1Be
fore
pregnancy
9LP
Tnd
VD
40nd
Swayne1908
220
20LP
Tnd
ndnd
nd16
16LP
Tnd
VD
24nd
Doran1906
120
21LP
T10
VD
40nd
Evans1899
120
20LP
T7
ndnd
ndEx
acou
stosa
ndRo
sati
1993
13nd
lt26
ndnd
NG
40(8)pretermgt
32(5)
nd
Burton
etal1989
8
nd13
LPT
18VD
40nd
nd15
LPT
14Fetald
emise
15weeks
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5VD
40nd
ndnd
LPT
5nd
ndnd
Rella
etal1980
110
12LP
Tnd
VD
27Neonatald
eath
Case Reports in Obstetrics and Gynecology 7Ta
ble1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)Pelosietal1995
113
15LP
S6
CS39
ndPelissie
r-Ko
morek
etal2012
110
13LP
T22
VD
352280
g
Mollicae
tal1996
188ndash17
10ndash19
LPT
gt10
CS(17)V
D(1)
ndgt7(18)gt
2500
g(17)lt
2500
g(1)
Febo
etal1997
3nd
12ndash19
LPT
NG
CS(2)abortio
n(1)
37-38
nd
Bonito
etal2007
5nd
9ndash15
LPT
35ndash145
CS(2)VD(3)
382
9+minus083
3200ndash4
072g
Vazqu
ezCa
macho
etal2009
17
16LP
T62
VD
4099
Makar
etal1989
112
17LP
T13500
gCS
38993950
gHorno
Liria
1962
116
16LP
Tnd
VD
403600
gAlanise
tal2008
17
12LP
T30
VD
382330
g
Ardizzone1955
27
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
88
LPT
ndMisc
arria
geat9weeks
2424
LPT
ndFetald
emise
at25
weeks
88
LPT
ndMisc
arria
geat8weeks
1616
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at14
weeks
2020
LPT
ndnd
ndnd
1616
LPT
ndnd
ndnd
2020
LPT
ndnd
ndnd
2020
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at13
weeks
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at13
weeks
1212
LPT
ndnd
ndnd
1616
LPT
ndFetald
emise
at17
weeks
88
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at12
weeks
1212
LPT
ndnd
ndnd
8 Case Reports in Obstetrics and Gynecology
Table1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)
Cozzi1967
16
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
nd16
LPT
ndVD
38nd
nd8
LPT
ndVD
40nd
nd12
LPT
ndVD
38nd
nd8
LPT
ndVD
40nd
nd16
LPT
ndVD
40nd
nd20
LPT
ndVD
36nd
nd8
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd16
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
Rochetetal1964
14nd
ndLP
T10
ndnd
ndSciann
ameo
etal
1996
120
20LP
T4
ndnd
nd
ndnot
determ
inedC
Scesarean
section
VDvaginaldeliveryLP
TlaparotomyLP
Slap
aroscopyV
AGvaginalsurgery
Case Reports in Obstetrics and Gynecology 9
Italiana di Medicina Perinatale SIMP) Naples (Italy) 19ndash21January 2017
Conflicts of Interest
The authors declare that there are no conflicts of interest
References
[1] S G Vitale A Tropea D Rossetti M Carnelli and A CiancildquoManagement of uterine leiomyomas in pregnancy review ofliteraturerdquo Updates in Surgery vol 65 no 3 pp 179ndash182 2013
[2] S K Sunkara M Khairy T El-Toukhy Y Khalaf and ACoomarasamy ldquoThe effect of intramural fibroids without uter-ine cavity involvement on the outcome of IVF treatment asystematic review and meta-analysisrdquo Human Reproductionvol 25 no 2 pp 418ndash429 2010
[3] V Lozza A Pieralli S Corioni M Longinotti and C PennaldquoMultiple laparotomic myomectomy during pregnancy a casereportrdquo Archives of Gynecology and Obstetrics vol 284 no 3pp 613ndash616 2011
[4] L Domenici V Di Donato M L Gasparri F Lecce J Caccettaand P B Panici ldquoLaparotomic myomectomy in the 16th weekof pregnancy a case reportrdquo Case Reports in Obstetrics andGynecology 5 pages 2014
[5] D E Lolis S N KalantaridouGMakrydimas et al ldquoSuccessfulmyomectomy during pregnancyrdquoHuman Reproduction vol 18no 8 pp 1699ndash1702 2003
[6] S De Carolis G Fatigante S Ferrazzani et al ldquoUterinemyomectomy in pregnant womenrdquo Fetal Diagnosis and Ther-apy vol 16 no 2 pp 116ndash119 2001
[7] N Bhatla B B Dash A Kriplani and N Agarwal ldquoMyomec-tomy during pregnancy a feasible optionrdquo Journal of Obstetricsand Gynaecology Research vol 35 no 1 pp 173ndash175 2009
[8] A Cagnacci D Pirillo S Malmusi S Arangino C Alessan-drini and A Volpe ldquoEarly outcome of myomectomy by laparo-tomy minilaparotomy and laparoscopically assisted minila-parotomy A randomized prospective studyrdquoHuman Reproduc-tion vol 18 no 12 pp 2590ndash2594 2003
[9] F Parazzini S Cipriani G Bulfoni et al ldquoCentiles of weightat term birth according to maternal nationality in a northernItalian regionrdquo Italian Journal of Gynaecology and Obstetricsvol 28 no 2 pp 52ndash56 2016
[10] S P Michalas F V Oreopoulou and J S PapageorgiouldquoMyomectomy during pregnancy and caesarean sectionrdquoHuman Reproduction vol 10 no 7 pp 1869ndash1870 1995
[11] E Danzer W Holzgreve C Batukan P Miny S Tercanli and IHoesli ldquoMyomectomy during the first trimester associated withfetal limb anomalies and hydrocephalus in a twin pregnancyrdquoPrenatal Diagnosis vol 21 no 10 pp 848ndash851 2001
[12] J G Joo J Inovay M Silhavy and Z Papp ldquoSuccessfulenucleation of a necrotizing fibroid causing oligohydramniosand fetal postural deformity in the 25th week of gestation Acase reportrdquo Journal of Reproductive Medicine vol 46 no 10pp 923ndash925 2001
[13] C Celik A Acar N Cicek K Gezginc and C Akyurek ldquoCanmyomectomy be performed during pregnancyrdquo Gynecologicand Obstetric Investigation vol 53 no 2 pp 79ndash83 2002
[14] U Hasbargen A Strauss M Summerer-Moustaki et alldquoMyomectomy as a pregnancy-preserving option in the care-fully selected patientrdquo Fetal Diagnosis and Therapy vol 17 no2 pp 101ndash103 2002
[15] C Umezurike and P Feyi-Waboso ldquoSuccessful myomectomyduring pregnancy a case reportrdquo Reproductive Health vol 2no 1 2005
[16] F Usifo R Macrae R Sharma I O Opemuyi and BOnwuzurike ldquoSuccessful myomectomy in early second trimes-ter of pregnancyrdquo Journal of Obstetrics and Gynaecology vol 27no 2 pp 196ndash197 2007
[17] F S Suwandinata S E Gruessner C O Omwandho and H RTinneberg ldquoPregnancy-preserving myomectomy preliminaryreport on a new surgical techniquerdquo European Journal ofContraception and Reproductive Health Care vol 13 no 3 pp323ndash326 2008 Erratum in European Journal of Contraceptionand Reproductive Health Care vol 13 no 4 article 438 2008
[18] G K Leite H A Korkes T Viana Ade A Pitorri G Kenj andN Sass ldquoMyomectomy in the second trimester of pregnancycase reportrdquo Revista Brasileira De Ginecologia E Obstetricia vol32 no 4 pp 198ndash201 2010
[19] P Isabu J Eigbefoh F Okogbo S Okunsanya and R EifediyildquoMyomectomy during second trimester pregnancy a casereportrdquo The Nigerian Postgraduate Medical Journal vol 17 no4 pp 324ndash326 2010
[20] K Leach L Khatain and K Tocce ldquoFirst trimester myomec-tomy as an alternative to termination of pregnancy in a womanwith a symptomatic uterine leiomyoma a case reportrdquo Journalof Medical Case Reports vol 5 article 571 2011
[21] S Doerga-Bachasingh V Karsdorp G Yo R Van Der Weidenand M Van Hooff ldquoSuccessful myomectomy of a bleedingmyoma in a twin pregnancyrdquo JRSM Short Reports vol 3 no 2article 13 2012
[22] P Jhalta S G Negi andV Sharma ldquoSuccessful myomectomy inearly pregnancy for a large asymptomatic uterine myoma casereportrdquo Pan African Medical Journal vol 13 no 24 article 228Article ID 228 2016
[23] C Kosmidis G Pantos C Efthimiadis I Gkoutziomitrou EGeorgakoudi and G Anthimidis ldquoLaparoscopic excision of apedunculated uterine leiomyoma in torsion as a cause of acuteabdomen at 10 weeks of pregnancyrdquo American Journal of CaseReports vol 16 pp 505ndash508 2015
[24] C Saccardi S Visentin M Noventa E Cosmi P Litta and SGizzo ldquoUncertainties about laparoscopic myomectomy duringpregnancy a lack of evidence or an inherited misconceptionA critical literature review starting from a peculiar caserdquoMinimally Invasive Therapy and Allied Technologies vol 24 no4 pp 189ndash194 2015
[25] M Obara Y Hatakeyama and Y Shimizu ldquoVaginal myomec-tomy for semipedunculated cervical myoma during pregnancyrdquoAmerican Journal of Perinatology Reports vol 4 no 1 pp 37ndash402014
[26] A Currie E Bradley M McEwen N Al-Shabibi and P DWillson ldquoLaparoscopic approach to fibroid torsion presentingas an acute abdomen in pregnancyrdquo Journal of the Society ofLaparoendoscopic Surgeons vol 17 no 4 pp 665ndash667 2013
[27] F Kobayashi E Kondoh J Hamanishi Y Kawamura KTatsumi and I Konishi ldquoPyomayoma during pregnancy a casereport and review of the literaturerdquo Journal of Obstetrics andGynaecology Research vol 39 no 1 pp 383ndash389 2013
[28] A MacCio C Madeddu P Kotsonis et al ldquoThree cases oflaparoscopic myomectomy performed during pregnancy for
10 Case Reports in Obstetrics and Gynecology
pedunculated uterine myomasrdquo Archives of Gynecology andObstetrics vol 286 no 5 pp 1209ndash1214 2012
[29] M Shafiee M Nor Azlin and D Arifuddin ldquoA successfulantenatal myomectomyrdquo Malaysian Family Physician vol 31no 7(2-3) pp 42ndash45 2012
[30] M Ardovino I Ardovino M A Castaldi A Monteverde NColacurci and L Cobellis ldquoLaparoscopic myomectomy of asubserous pedunculated fibroid at 14 weeks of pregnancy a casereportrdquo Journal of Medical Case Reports vol 5 article 545 2011
[31] A Muller Vranjes S Sijanovic D Vidosavljevic Z Kasac andK Abicic Zuljevic ldquoSurgical treatment of large smooth muscletumor of uncertain malignant potential during pregnancyrdquoMedicinski Glasnik Journal vol 8 no 2 pp 290ndash292 2011
[32] C E Son J S Choi J H Lee S W Jeon J W Bae and S SSeo ldquoA case of laparoscopic myomectomy performed duringpregnancy for subserosal uterine myomardquo Journal of Obstetricsand Gynaecology vol 31 no 2 pp 180ndash181 2011
[33] M Kasum ldquoHemoperitoneum caused by a bleeding myoma inpregnancyrdquo Acta Clinica Croatica vol 49 no 2 pp 197ndash2002010
[34] F Fanfani C Rossitto A Fagotti P Rosati V Gallotta andG Scambia ldquoLaparoscopic myomectomy at 25 weeks of preg-nancy case reportrdquo Journal of Minimally Invasive Gynecologyvol 17 no 1 pp 91ndash93 2010
[35] A S Adeyemi S E Akinola and A I Isawumi ldquoAntepartummyomectomywith a live term deliverymdasha case reportrdquoNigerianJournal of Clinical Practice vol 10 no 4 pp 346ndash348 2007
[36] J E N Okonkwo and G O Udigwe ldquoMyomectomy in preg-nancyrdquo Journal of Obstetrics and Gynaecology vol 27 no 6 pp628ndash630 2007
[37] L Dracea and D Codreanu ldquoVaginal birth after extensivemyomectomy during pregnancy in a 39-year-old nulliparouswomanrdquo Journal of Obstetrics and Gynaecology vol 26 no 4pp 374ndash375 2006
[38] L Melgrati A Damiani G Franzoni M Marziali and FSesti ldquoIsobaric (gasless) laparoscopic myomectomy duringpregnancyrdquo Journal of Minimally Invasive Gynecology vol 12no 4 pp 379ndash381 2005
[39] L Sentilhes F Sergent E Verspyck A Gravier H Roman andL Marpeau ldquoLaparoscopic myomectomy during pregnancyresulting in septic necrosis of the myometriumrdquo BJOG AnInternational Journal of Obstetrics and Gynaecology vol 110 no9 pp 876ndash878 2003
[40] J Donnez C Pirard M Smets R Polet C Feger and JSquifflet ldquoUnusual growth of a myoma during pregnancyrdquoFertility and Sterility vol 78 no 3 pp 632ndash633 2002
[41] HWilliamson ldquoEnucleation during the seventh lunarmonth ofpregnancy of a uterine fibro-myomardquo Proceedings of the RoyalSociety of Medicine vol 1 pp 73ndash78 1908
[42] J Stewart ldquoEnucleation of fibro-myoma of uterus duringpregnancyrdquo British Medical Journal vol 1 no 2358 pp 548ndash549 1906
[43] A C Wittich E R Salminen M K Yancey and G RMarkenson ldquoMyomectomy during early pregnancyrdquo MilitaryMedicine vol 165 no 2 pp 162ndash164 2000
[44] M Majid G Q Khan and L MWei ldquoInevitable myomectomyin pregnancyrdquo Journal of Obstetrics and Gynaecology vol 17 no4 pp 377ndash378 1997
[45] A C Algara A G Rodrıguez A C Vazquez et al ldquoLaparo-scopic approach for fibroid removal at 18 weeks of pregnancyrdquoSurgical Technology International vol 27 pp 195ndash197 2015
[46] C Lockyer ldquoMultiple myomectomy in the sixth month ofpregnancy labour at termrdquo Proceedings of the Royal Society ofMedicine vol 7 pp 221ndash225 1914
[47] C A von Hoffmann ldquoAbdominal myomectomy during preg-nancyrdquoCalifornia State Journal ofMedicine vol 9 no 5 pp 197ndash200 1911
[48] H R Andrews ldquoMyomectomy during pregnancyrdquo Proceedingsof the Royal Society of Medicine vol 3 pp 164ndash166 1910
[49] WC Swayne ldquoAbdominal myomectomy during pregnancyrdquoProceedings of the Royal Society of Medicine vol 1 pp 129ndash1321908
[50] A Doran ldquoMyomectomy during pregnancy and labour at termin an elderly primipara with notes on similar casesrdquo BritishMedical Journal vol 2 no 2395 pp 1446ndash1447 1906
[51] H M Evans ldquoA case of myomectomy for subperitoneal myomacomplicating pregnancyrdquo British Medical Journal vol 2 no2033 p 1673 1899
[52] C Exacoustos and P Rosati ldquoUltrasound diagnosis of uterinemyomas and complications in pregnancyrdquoObstetrics and Gyne-cology vol 82 no 1 pp 97ndash101 1993
[53] C A Burton D A Grimes and C M March ldquoSurgicalmanagement of leiomyomata during pregnancyrdquoObstetrics andGynecology vol 74 no 5 pp 707ndash709 1989
[54] R Rella E Bonfadini Bossi and D Fagnani ldquoMyomectomy inpregnancy Description of an interesting clinical caserdquoMinervaGinecologica vol 32 no 4 pp 267ndash269 1980
[55] M A Pelosi M A Pelosi III and S Giblin ldquoLaparoscopicremoval of a 1500-g symptomatic myoma during the secondtrimester of pregnancyrdquo American Association of GynecologicLaparoscopists vol 2 no 4 pp 457ndash462 1995
[56] A Pelissier-Komorek J Hamm S Bonneau E Derniaux CHoeffel-Fornes and O Graesslin ldquoMyoma and pregnancywhen medical treatment is not sufficientrdquo Journal de Gynecolo-gie Obstetrique et Biologie de la Reproduction vol 41 no 3 pp307ndash310 2012
[57] G Mollica L Pittini E Minganti G Perri and F PansinildquoElective uterine myomectomy in pregnant womenrdquo Clinicaland Experimental Obstetrics and Gynecology vol 23 no 3 pp168ndash172 1996
[58] G Febo M Tessarolo L Leo S Arduino T Wierdis and LLanza ldquoSurgical management of leiomyomata in pregnancyrdquoClinical and ExperimentalObstetrics andGynecology vol 24 no2 pp 76ndash78 1997
[59] M Bonito L Gulemı R Basili and D Roselli ldquoMyomectomyduring the first and second trimester of pregnancyrdquoClinical andExperimental Obstetrics and Gynecology vol 34 no 3 pp 149ndash150 2007
[60] E E Vazquez Camacho E Cabrera Carranco and R GSanchez Herrera ldquoPedunculated twisted myoma and preg-nancy Case reportrdquoGinecologia y Obstetricia de Mexico vol 77no 9 pp 441ndash444 2009
[61] A P Makar E A Schatteman I B Vergote and E DesmedtldquoMyomectomy during pregnancy uncommon case reportrdquoActa Chirurgica Belgica vol 89 no 4 pp 212ndash214 1989
[62] R Horno Liria ldquoMyomectomy and pregnancyrdquo Rev Esp ObstetGinecol vol 19 pp 214ndash218 1962
[63] M C Alanis A Mitra and N Koklanaris ldquoPreoperativemagnetic resonance imaging and antepartummyomectomy of agiant pedunculated leiomyomardquoObstetrics and Gynecology vol111 no 2 part 2 pp 577ndash579 2008
Case Reports in Obstetrics and Gynecology 11
[64] G Ardizzone ldquoClinical and statistical considerations of 27cases of myomectomy in pregnancyrdquo Rivista di Ostetricia eGinecologia vol 10 no 12 pp 848ndash860 1955
[65] M Cozzi ldquoMyomectomy in pregnancyrdquo Quaderni di ClinicaOstetrica e Ginecologica vol 22 no 3 pp 171ndash180 1967
[66] Y Rochet M Cognat D Dargent and E Pollosson ldquoOnmyomectomy during pregnance (apropos of 14 observations)rdquoBulletin de la Federation des Societes de Gynecologie etDobstetrique de Langue Francaise vol 16 pp 462ndash463 1964
[67] F Sciannameo G Madami C Madami et al ldquoTorsion ofuterine fibroma associated with inguinal incarcerated hernia inpregnancy Case reportrdquo Minerva Ginecologica vol 48 no 11pp 501ndash504 1996
Submit your manuscripts athttpswwwhindawicom
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
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Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
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Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
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Diabetes ResearchJournal of
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Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
Case Reports in Obstetrics and Gynecology 7Ta
ble1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)Pelosietal1995
113
15LP
S6
CS39
ndPelissie
r-Ko
morek
etal2012
110
13LP
T22
VD
352280
g
Mollicae
tal1996
188ndash17
10ndash19
LPT
gt10
CS(17)V
D(1)
ndgt7(18)gt
2500
g(17)lt
2500
g(1)
Febo
etal1997
3nd
12ndash19
LPT
NG
CS(2)abortio
n(1)
37-38
nd
Bonito
etal2007
5nd
9ndash15
LPT
35ndash145
CS(2)VD(3)
382
9+minus083
3200ndash4
072g
Vazqu
ezCa
macho
etal2009
17
16LP
T62
VD
4099
Makar
etal1989
112
17LP
T13500
gCS
38993950
gHorno
Liria
1962
116
16LP
Tnd
VD
403600
gAlanise
tal2008
17
12LP
T30
VD
382330
g
Ardizzone1955
27
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
88
LPT
ndMisc
arria
geat9weeks
2424
LPT
ndFetald
emise
at25
weeks
88
LPT
ndMisc
arria
geat8weeks
1616
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at14
weeks
2020
LPT
ndnd
ndnd
1616
LPT
ndnd
ndnd
2020
LPT
ndnd
ndnd
2020
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at13
weeks
88
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at13
weeks
1212
LPT
ndnd
ndnd
1616
LPT
ndFetald
emise
at17
weeks
88
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
1212
LPT
ndnd
ndnd
88
LPT
ndnd
ndnd
1212
LPT
ndFetald
emise
at12
weeks
1212
LPT
ndnd
ndnd
8 Case Reports in Obstetrics and Gynecology
Table1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)
Cozzi1967
16
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
nd16
LPT
ndVD
38nd
nd8
LPT
ndVD
40nd
nd12
LPT
ndVD
38nd
nd8
LPT
ndVD
40nd
nd16
LPT
ndVD
40nd
nd20
LPT
ndVD
36nd
nd8
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd16
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
Rochetetal1964
14nd
ndLP
T10
ndnd
ndSciann
ameo
etal
1996
120
20LP
T4
ndnd
nd
ndnot
determ
inedC
Scesarean
section
VDvaginaldeliveryLP
TlaparotomyLP
Slap
aroscopyV
AGvaginalsurgery
Case Reports in Obstetrics and Gynecology 9
Italiana di Medicina Perinatale SIMP) Naples (Italy) 19ndash21January 2017
Conflicts of Interest
The authors declare that there are no conflicts of interest
References
[1] S G Vitale A Tropea D Rossetti M Carnelli and A CiancildquoManagement of uterine leiomyomas in pregnancy review ofliteraturerdquo Updates in Surgery vol 65 no 3 pp 179ndash182 2013
[2] S K Sunkara M Khairy T El-Toukhy Y Khalaf and ACoomarasamy ldquoThe effect of intramural fibroids without uter-ine cavity involvement on the outcome of IVF treatment asystematic review and meta-analysisrdquo Human Reproductionvol 25 no 2 pp 418ndash429 2010
[3] V Lozza A Pieralli S Corioni M Longinotti and C PennaldquoMultiple laparotomic myomectomy during pregnancy a casereportrdquo Archives of Gynecology and Obstetrics vol 284 no 3pp 613ndash616 2011
[4] L Domenici V Di Donato M L Gasparri F Lecce J Caccettaand P B Panici ldquoLaparotomic myomectomy in the 16th weekof pregnancy a case reportrdquo Case Reports in Obstetrics andGynecology 5 pages 2014
[5] D E Lolis S N KalantaridouGMakrydimas et al ldquoSuccessfulmyomectomy during pregnancyrdquoHuman Reproduction vol 18no 8 pp 1699ndash1702 2003
[6] S De Carolis G Fatigante S Ferrazzani et al ldquoUterinemyomectomy in pregnant womenrdquo Fetal Diagnosis and Ther-apy vol 16 no 2 pp 116ndash119 2001
[7] N Bhatla B B Dash A Kriplani and N Agarwal ldquoMyomec-tomy during pregnancy a feasible optionrdquo Journal of Obstetricsand Gynaecology Research vol 35 no 1 pp 173ndash175 2009
[8] A Cagnacci D Pirillo S Malmusi S Arangino C Alessan-drini and A Volpe ldquoEarly outcome of myomectomy by laparo-tomy minilaparotomy and laparoscopically assisted minila-parotomy A randomized prospective studyrdquoHuman Reproduc-tion vol 18 no 12 pp 2590ndash2594 2003
[9] F Parazzini S Cipriani G Bulfoni et al ldquoCentiles of weightat term birth according to maternal nationality in a northernItalian regionrdquo Italian Journal of Gynaecology and Obstetricsvol 28 no 2 pp 52ndash56 2016
[10] S P Michalas F V Oreopoulou and J S PapageorgiouldquoMyomectomy during pregnancy and caesarean sectionrdquoHuman Reproduction vol 10 no 7 pp 1869ndash1870 1995
[11] E Danzer W Holzgreve C Batukan P Miny S Tercanli and IHoesli ldquoMyomectomy during the first trimester associated withfetal limb anomalies and hydrocephalus in a twin pregnancyrdquoPrenatal Diagnosis vol 21 no 10 pp 848ndash851 2001
[12] J G Joo J Inovay M Silhavy and Z Papp ldquoSuccessfulenucleation of a necrotizing fibroid causing oligohydramniosand fetal postural deformity in the 25th week of gestation Acase reportrdquo Journal of Reproductive Medicine vol 46 no 10pp 923ndash925 2001
[13] C Celik A Acar N Cicek K Gezginc and C Akyurek ldquoCanmyomectomy be performed during pregnancyrdquo Gynecologicand Obstetric Investigation vol 53 no 2 pp 79ndash83 2002
[14] U Hasbargen A Strauss M Summerer-Moustaki et alldquoMyomectomy as a pregnancy-preserving option in the care-fully selected patientrdquo Fetal Diagnosis and Therapy vol 17 no2 pp 101ndash103 2002
[15] C Umezurike and P Feyi-Waboso ldquoSuccessful myomectomyduring pregnancy a case reportrdquo Reproductive Health vol 2no 1 2005
[16] F Usifo R Macrae R Sharma I O Opemuyi and BOnwuzurike ldquoSuccessful myomectomy in early second trimes-ter of pregnancyrdquo Journal of Obstetrics and Gynaecology vol 27no 2 pp 196ndash197 2007
[17] F S Suwandinata S E Gruessner C O Omwandho and H RTinneberg ldquoPregnancy-preserving myomectomy preliminaryreport on a new surgical techniquerdquo European Journal ofContraception and Reproductive Health Care vol 13 no 3 pp323ndash326 2008 Erratum in European Journal of Contraceptionand Reproductive Health Care vol 13 no 4 article 438 2008
[18] G K Leite H A Korkes T Viana Ade A Pitorri G Kenj andN Sass ldquoMyomectomy in the second trimester of pregnancycase reportrdquo Revista Brasileira De Ginecologia E Obstetricia vol32 no 4 pp 198ndash201 2010
[19] P Isabu J Eigbefoh F Okogbo S Okunsanya and R EifediyildquoMyomectomy during second trimester pregnancy a casereportrdquo The Nigerian Postgraduate Medical Journal vol 17 no4 pp 324ndash326 2010
[20] K Leach L Khatain and K Tocce ldquoFirst trimester myomec-tomy as an alternative to termination of pregnancy in a womanwith a symptomatic uterine leiomyoma a case reportrdquo Journalof Medical Case Reports vol 5 article 571 2011
[21] S Doerga-Bachasingh V Karsdorp G Yo R Van Der Weidenand M Van Hooff ldquoSuccessful myomectomy of a bleedingmyoma in a twin pregnancyrdquo JRSM Short Reports vol 3 no 2article 13 2012
[22] P Jhalta S G Negi andV Sharma ldquoSuccessful myomectomy inearly pregnancy for a large asymptomatic uterine myoma casereportrdquo Pan African Medical Journal vol 13 no 24 article 228Article ID 228 2016
[23] C Kosmidis G Pantos C Efthimiadis I Gkoutziomitrou EGeorgakoudi and G Anthimidis ldquoLaparoscopic excision of apedunculated uterine leiomyoma in torsion as a cause of acuteabdomen at 10 weeks of pregnancyrdquo American Journal of CaseReports vol 16 pp 505ndash508 2015
[24] C Saccardi S Visentin M Noventa E Cosmi P Litta and SGizzo ldquoUncertainties about laparoscopic myomectomy duringpregnancy a lack of evidence or an inherited misconceptionA critical literature review starting from a peculiar caserdquoMinimally Invasive Therapy and Allied Technologies vol 24 no4 pp 189ndash194 2015
[25] M Obara Y Hatakeyama and Y Shimizu ldquoVaginal myomec-tomy for semipedunculated cervical myoma during pregnancyrdquoAmerican Journal of Perinatology Reports vol 4 no 1 pp 37ndash402014
[26] A Currie E Bradley M McEwen N Al-Shabibi and P DWillson ldquoLaparoscopic approach to fibroid torsion presentingas an acute abdomen in pregnancyrdquo Journal of the Society ofLaparoendoscopic Surgeons vol 17 no 4 pp 665ndash667 2013
[27] F Kobayashi E Kondoh J Hamanishi Y Kawamura KTatsumi and I Konishi ldquoPyomayoma during pregnancy a casereport and review of the literaturerdquo Journal of Obstetrics andGynaecology Research vol 39 no 1 pp 383ndash389 2013
[28] A MacCio C Madeddu P Kotsonis et al ldquoThree cases oflaparoscopic myomectomy performed during pregnancy for
10 Case Reports in Obstetrics and Gynecology
pedunculated uterine myomasrdquo Archives of Gynecology andObstetrics vol 286 no 5 pp 1209ndash1214 2012
[29] M Shafiee M Nor Azlin and D Arifuddin ldquoA successfulantenatal myomectomyrdquo Malaysian Family Physician vol 31no 7(2-3) pp 42ndash45 2012
[30] M Ardovino I Ardovino M A Castaldi A Monteverde NColacurci and L Cobellis ldquoLaparoscopic myomectomy of asubserous pedunculated fibroid at 14 weeks of pregnancy a casereportrdquo Journal of Medical Case Reports vol 5 article 545 2011
[31] A Muller Vranjes S Sijanovic D Vidosavljevic Z Kasac andK Abicic Zuljevic ldquoSurgical treatment of large smooth muscletumor of uncertain malignant potential during pregnancyrdquoMedicinski Glasnik Journal vol 8 no 2 pp 290ndash292 2011
[32] C E Son J S Choi J H Lee S W Jeon J W Bae and S SSeo ldquoA case of laparoscopic myomectomy performed duringpregnancy for subserosal uterine myomardquo Journal of Obstetricsand Gynaecology vol 31 no 2 pp 180ndash181 2011
[33] M Kasum ldquoHemoperitoneum caused by a bleeding myoma inpregnancyrdquo Acta Clinica Croatica vol 49 no 2 pp 197ndash2002010
[34] F Fanfani C Rossitto A Fagotti P Rosati V Gallotta andG Scambia ldquoLaparoscopic myomectomy at 25 weeks of preg-nancy case reportrdquo Journal of Minimally Invasive Gynecologyvol 17 no 1 pp 91ndash93 2010
[35] A S Adeyemi S E Akinola and A I Isawumi ldquoAntepartummyomectomywith a live term deliverymdasha case reportrdquoNigerianJournal of Clinical Practice vol 10 no 4 pp 346ndash348 2007
[36] J E N Okonkwo and G O Udigwe ldquoMyomectomy in preg-nancyrdquo Journal of Obstetrics and Gynaecology vol 27 no 6 pp628ndash630 2007
[37] L Dracea and D Codreanu ldquoVaginal birth after extensivemyomectomy during pregnancy in a 39-year-old nulliparouswomanrdquo Journal of Obstetrics and Gynaecology vol 26 no 4pp 374ndash375 2006
[38] L Melgrati A Damiani G Franzoni M Marziali and FSesti ldquoIsobaric (gasless) laparoscopic myomectomy duringpregnancyrdquo Journal of Minimally Invasive Gynecology vol 12no 4 pp 379ndash381 2005
[39] L Sentilhes F Sergent E Verspyck A Gravier H Roman andL Marpeau ldquoLaparoscopic myomectomy during pregnancyresulting in septic necrosis of the myometriumrdquo BJOG AnInternational Journal of Obstetrics and Gynaecology vol 110 no9 pp 876ndash878 2003
[40] J Donnez C Pirard M Smets R Polet C Feger and JSquifflet ldquoUnusual growth of a myoma during pregnancyrdquoFertility and Sterility vol 78 no 3 pp 632ndash633 2002
[41] HWilliamson ldquoEnucleation during the seventh lunarmonth ofpregnancy of a uterine fibro-myomardquo Proceedings of the RoyalSociety of Medicine vol 1 pp 73ndash78 1908
[42] J Stewart ldquoEnucleation of fibro-myoma of uterus duringpregnancyrdquo British Medical Journal vol 1 no 2358 pp 548ndash549 1906
[43] A C Wittich E R Salminen M K Yancey and G RMarkenson ldquoMyomectomy during early pregnancyrdquo MilitaryMedicine vol 165 no 2 pp 162ndash164 2000
[44] M Majid G Q Khan and L MWei ldquoInevitable myomectomyin pregnancyrdquo Journal of Obstetrics and Gynaecology vol 17 no4 pp 377ndash378 1997
[45] A C Algara A G Rodrıguez A C Vazquez et al ldquoLaparo-scopic approach for fibroid removal at 18 weeks of pregnancyrdquoSurgical Technology International vol 27 pp 195ndash197 2015
[46] C Lockyer ldquoMultiple myomectomy in the sixth month ofpregnancy labour at termrdquo Proceedings of the Royal Society ofMedicine vol 7 pp 221ndash225 1914
[47] C A von Hoffmann ldquoAbdominal myomectomy during preg-nancyrdquoCalifornia State Journal ofMedicine vol 9 no 5 pp 197ndash200 1911
[48] H R Andrews ldquoMyomectomy during pregnancyrdquo Proceedingsof the Royal Society of Medicine vol 3 pp 164ndash166 1910
[49] WC Swayne ldquoAbdominal myomectomy during pregnancyrdquoProceedings of the Royal Society of Medicine vol 1 pp 129ndash1321908
[50] A Doran ldquoMyomectomy during pregnancy and labour at termin an elderly primipara with notes on similar casesrdquo BritishMedical Journal vol 2 no 2395 pp 1446ndash1447 1906
[51] H M Evans ldquoA case of myomectomy for subperitoneal myomacomplicating pregnancyrdquo British Medical Journal vol 2 no2033 p 1673 1899
[52] C Exacoustos and P Rosati ldquoUltrasound diagnosis of uterinemyomas and complications in pregnancyrdquoObstetrics and Gyne-cology vol 82 no 1 pp 97ndash101 1993
[53] C A Burton D A Grimes and C M March ldquoSurgicalmanagement of leiomyomata during pregnancyrdquoObstetrics andGynecology vol 74 no 5 pp 707ndash709 1989
[54] R Rella E Bonfadini Bossi and D Fagnani ldquoMyomectomy inpregnancy Description of an interesting clinical caserdquoMinervaGinecologica vol 32 no 4 pp 267ndash269 1980
[55] M A Pelosi M A Pelosi III and S Giblin ldquoLaparoscopicremoval of a 1500-g symptomatic myoma during the secondtrimester of pregnancyrdquo American Association of GynecologicLaparoscopists vol 2 no 4 pp 457ndash462 1995
[56] A Pelissier-Komorek J Hamm S Bonneau E Derniaux CHoeffel-Fornes and O Graesslin ldquoMyoma and pregnancywhen medical treatment is not sufficientrdquo Journal de Gynecolo-gie Obstetrique et Biologie de la Reproduction vol 41 no 3 pp307ndash310 2012
[57] G Mollica L Pittini E Minganti G Perri and F PansinildquoElective uterine myomectomy in pregnant womenrdquo Clinicaland Experimental Obstetrics and Gynecology vol 23 no 3 pp168ndash172 1996
[58] G Febo M Tessarolo L Leo S Arduino T Wierdis and LLanza ldquoSurgical management of leiomyomata in pregnancyrdquoClinical and ExperimentalObstetrics andGynecology vol 24 no2 pp 76ndash78 1997
[59] M Bonito L Gulemı R Basili and D Roselli ldquoMyomectomyduring the first and second trimester of pregnancyrdquoClinical andExperimental Obstetrics and Gynecology vol 34 no 3 pp 149ndash150 2007
[60] E E Vazquez Camacho E Cabrera Carranco and R GSanchez Herrera ldquoPedunculated twisted myoma and preg-nancy Case reportrdquoGinecologia y Obstetricia de Mexico vol 77no 9 pp 441ndash444 2009
[61] A P Makar E A Schatteman I B Vergote and E DesmedtldquoMyomectomy during pregnancy uncommon case reportrdquoActa Chirurgica Belgica vol 89 no 4 pp 212ndash214 1989
[62] R Horno Liria ldquoMyomectomy and pregnancyrdquo Rev Esp ObstetGinecol vol 19 pp 214ndash218 1962
[63] M C Alanis A Mitra and N Koklanaris ldquoPreoperativemagnetic resonance imaging and antepartummyomectomy of agiant pedunculated leiomyomardquoObstetrics and Gynecology vol111 no 2 part 2 pp 577ndash579 2008
Case Reports in Obstetrics and Gynecology 11
[64] G Ardizzone ldquoClinical and statistical considerations of 27cases of myomectomy in pregnancyrdquo Rivista di Ostetricia eGinecologia vol 10 no 12 pp 848ndash860 1955
[65] M Cozzi ldquoMyomectomy in pregnancyrdquo Quaderni di ClinicaOstetrica e Ginecologica vol 22 no 3 pp 171ndash180 1967
[66] Y Rochet M Cognat D Dargent and E Pollosson ldquoOnmyomectomy during pregnance (apropos of 14 observations)rdquoBulletin de la Federation des Societes de Gynecologie etDobstetrique de Langue Francaise vol 16 pp 462ndash463 1964
[67] F Sciannameo G Madami C Madami et al ldquoTorsion ofuterine fibroma associated with inguinal incarcerated hernia inpregnancy Case reportrdquo Minerva Ginecologica vol 48 no 11pp 501ndash504 1996
Submit your manuscripts athttpswwwhindawicom
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Diabetes ResearchJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
8 Case Reports in Obstetrics and Gynecology
Table1Con
tinued
Reference
Num
bero
fpatie
nts
Gestatio
nalage
atdiagno
sis(w
eeks)
Gestatio
nalage
atmyomectomy
(weeks)
Type
ofsurgery
Fibroidmaxim
umvolume(cm
)Mod
eofd
elivery
Gestatio
nalage
atdelivery
Neonatal
outcom
e(Apgar
birthw
eightpH
)
Cozzi1967
16
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
nd16
LPT
ndVD
38nd
nd8
LPT
ndVD
40nd
nd12
LPT
ndVD
38nd
nd8
LPT
ndVD
40nd
nd16
LPT
ndVD
40nd
nd20
LPT
ndVD
36nd
nd8
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd12
LPT
ndVD
40nd
nd16
LPT
ndVD
40nd
nd8
LPT
ndVD
40nd
Rochetetal1964
14nd
ndLP
T10
ndnd
ndSciann
ameo
etal
1996
120
20LP
T4
ndnd
nd
ndnot
determ
inedC
Scesarean
section
VDvaginaldeliveryLP
TlaparotomyLP
Slap
aroscopyV
AGvaginalsurgery
Case Reports in Obstetrics and Gynecology 9
Italiana di Medicina Perinatale SIMP) Naples (Italy) 19ndash21January 2017
Conflicts of Interest
The authors declare that there are no conflicts of interest
References
[1] S G Vitale A Tropea D Rossetti M Carnelli and A CiancildquoManagement of uterine leiomyomas in pregnancy review ofliteraturerdquo Updates in Surgery vol 65 no 3 pp 179ndash182 2013
[2] S K Sunkara M Khairy T El-Toukhy Y Khalaf and ACoomarasamy ldquoThe effect of intramural fibroids without uter-ine cavity involvement on the outcome of IVF treatment asystematic review and meta-analysisrdquo Human Reproductionvol 25 no 2 pp 418ndash429 2010
[3] V Lozza A Pieralli S Corioni M Longinotti and C PennaldquoMultiple laparotomic myomectomy during pregnancy a casereportrdquo Archives of Gynecology and Obstetrics vol 284 no 3pp 613ndash616 2011
[4] L Domenici V Di Donato M L Gasparri F Lecce J Caccettaand P B Panici ldquoLaparotomic myomectomy in the 16th weekof pregnancy a case reportrdquo Case Reports in Obstetrics andGynecology 5 pages 2014
[5] D E Lolis S N KalantaridouGMakrydimas et al ldquoSuccessfulmyomectomy during pregnancyrdquoHuman Reproduction vol 18no 8 pp 1699ndash1702 2003
[6] S De Carolis G Fatigante S Ferrazzani et al ldquoUterinemyomectomy in pregnant womenrdquo Fetal Diagnosis and Ther-apy vol 16 no 2 pp 116ndash119 2001
[7] N Bhatla B B Dash A Kriplani and N Agarwal ldquoMyomec-tomy during pregnancy a feasible optionrdquo Journal of Obstetricsand Gynaecology Research vol 35 no 1 pp 173ndash175 2009
[8] A Cagnacci D Pirillo S Malmusi S Arangino C Alessan-drini and A Volpe ldquoEarly outcome of myomectomy by laparo-tomy minilaparotomy and laparoscopically assisted minila-parotomy A randomized prospective studyrdquoHuman Reproduc-tion vol 18 no 12 pp 2590ndash2594 2003
[9] F Parazzini S Cipriani G Bulfoni et al ldquoCentiles of weightat term birth according to maternal nationality in a northernItalian regionrdquo Italian Journal of Gynaecology and Obstetricsvol 28 no 2 pp 52ndash56 2016
[10] S P Michalas F V Oreopoulou and J S PapageorgiouldquoMyomectomy during pregnancy and caesarean sectionrdquoHuman Reproduction vol 10 no 7 pp 1869ndash1870 1995
[11] E Danzer W Holzgreve C Batukan P Miny S Tercanli and IHoesli ldquoMyomectomy during the first trimester associated withfetal limb anomalies and hydrocephalus in a twin pregnancyrdquoPrenatal Diagnosis vol 21 no 10 pp 848ndash851 2001
[12] J G Joo J Inovay M Silhavy and Z Papp ldquoSuccessfulenucleation of a necrotizing fibroid causing oligohydramniosand fetal postural deformity in the 25th week of gestation Acase reportrdquo Journal of Reproductive Medicine vol 46 no 10pp 923ndash925 2001
[13] C Celik A Acar N Cicek K Gezginc and C Akyurek ldquoCanmyomectomy be performed during pregnancyrdquo Gynecologicand Obstetric Investigation vol 53 no 2 pp 79ndash83 2002
[14] U Hasbargen A Strauss M Summerer-Moustaki et alldquoMyomectomy as a pregnancy-preserving option in the care-fully selected patientrdquo Fetal Diagnosis and Therapy vol 17 no2 pp 101ndash103 2002
[15] C Umezurike and P Feyi-Waboso ldquoSuccessful myomectomyduring pregnancy a case reportrdquo Reproductive Health vol 2no 1 2005
[16] F Usifo R Macrae R Sharma I O Opemuyi and BOnwuzurike ldquoSuccessful myomectomy in early second trimes-ter of pregnancyrdquo Journal of Obstetrics and Gynaecology vol 27no 2 pp 196ndash197 2007
[17] F S Suwandinata S E Gruessner C O Omwandho and H RTinneberg ldquoPregnancy-preserving myomectomy preliminaryreport on a new surgical techniquerdquo European Journal ofContraception and Reproductive Health Care vol 13 no 3 pp323ndash326 2008 Erratum in European Journal of Contraceptionand Reproductive Health Care vol 13 no 4 article 438 2008
[18] G K Leite H A Korkes T Viana Ade A Pitorri G Kenj andN Sass ldquoMyomectomy in the second trimester of pregnancycase reportrdquo Revista Brasileira De Ginecologia E Obstetricia vol32 no 4 pp 198ndash201 2010
[19] P Isabu J Eigbefoh F Okogbo S Okunsanya and R EifediyildquoMyomectomy during second trimester pregnancy a casereportrdquo The Nigerian Postgraduate Medical Journal vol 17 no4 pp 324ndash326 2010
[20] K Leach L Khatain and K Tocce ldquoFirst trimester myomec-tomy as an alternative to termination of pregnancy in a womanwith a symptomatic uterine leiomyoma a case reportrdquo Journalof Medical Case Reports vol 5 article 571 2011
[21] S Doerga-Bachasingh V Karsdorp G Yo R Van Der Weidenand M Van Hooff ldquoSuccessful myomectomy of a bleedingmyoma in a twin pregnancyrdquo JRSM Short Reports vol 3 no 2article 13 2012
[22] P Jhalta S G Negi andV Sharma ldquoSuccessful myomectomy inearly pregnancy for a large asymptomatic uterine myoma casereportrdquo Pan African Medical Journal vol 13 no 24 article 228Article ID 228 2016
[23] C Kosmidis G Pantos C Efthimiadis I Gkoutziomitrou EGeorgakoudi and G Anthimidis ldquoLaparoscopic excision of apedunculated uterine leiomyoma in torsion as a cause of acuteabdomen at 10 weeks of pregnancyrdquo American Journal of CaseReports vol 16 pp 505ndash508 2015
[24] C Saccardi S Visentin M Noventa E Cosmi P Litta and SGizzo ldquoUncertainties about laparoscopic myomectomy duringpregnancy a lack of evidence or an inherited misconceptionA critical literature review starting from a peculiar caserdquoMinimally Invasive Therapy and Allied Technologies vol 24 no4 pp 189ndash194 2015
[25] M Obara Y Hatakeyama and Y Shimizu ldquoVaginal myomec-tomy for semipedunculated cervical myoma during pregnancyrdquoAmerican Journal of Perinatology Reports vol 4 no 1 pp 37ndash402014
[26] A Currie E Bradley M McEwen N Al-Shabibi and P DWillson ldquoLaparoscopic approach to fibroid torsion presentingas an acute abdomen in pregnancyrdquo Journal of the Society ofLaparoendoscopic Surgeons vol 17 no 4 pp 665ndash667 2013
[27] F Kobayashi E Kondoh J Hamanishi Y Kawamura KTatsumi and I Konishi ldquoPyomayoma during pregnancy a casereport and review of the literaturerdquo Journal of Obstetrics andGynaecology Research vol 39 no 1 pp 383ndash389 2013
[28] A MacCio C Madeddu P Kotsonis et al ldquoThree cases oflaparoscopic myomectomy performed during pregnancy for
10 Case Reports in Obstetrics and Gynecology
pedunculated uterine myomasrdquo Archives of Gynecology andObstetrics vol 286 no 5 pp 1209ndash1214 2012
[29] M Shafiee M Nor Azlin and D Arifuddin ldquoA successfulantenatal myomectomyrdquo Malaysian Family Physician vol 31no 7(2-3) pp 42ndash45 2012
[30] M Ardovino I Ardovino M A Castaldi A Monteverde NColacurci and L Cobellis ldquoLaparoscopic myomectomy of asubserous pedunculated fibroid at 14 weeks of pregnancy a casereportrdquo Journal of Medical Case Reports vol 5 article 545 2011
[31] A Muller Vranjes S Sijanovic D Vidosavljevic Z Kasac andK Abicic Zuljevic ldquoSurgical treatment of large smooth muscletumor of uncertain malignant potential during pregnancyrdquoMedicinski Glasnik Journal vol 8 no 2 pp 290ndash292 2011
[32] C E Son J S Choi J H Lee S W Jeon J W Bae and S SSeo ldquoA case of laparoscopic myomectomy performed duringpregnancy for subserosal uterine myomardquo Journal of Obstetricsand Gynaecology vol 31 no 2 pp 180ndash181 2011
[33] M Kasum ldquoHemoperitoneum caused by a bleeding myoma inpregnancyrdquo Acta Clinica Croatica vol 49 no 2 pp 197ndash2002010
[34] F Fanfani C Rossitto A Fagotti P Rosati V Gallotta andG Scambia ldquoLaparoscopic myomectomy at 25 weeks of preg-nancy case reportrdquo Journal of Minimally Invasive Gynecologyvol 17 no 1 pp 91ndash93 2010
[35] A S Adeyemi S E Akinola and A I Isawumi ldquoAntepartummyomectomywith a live term deliverymdasha case reportrdquoNigerianJournal of Clinical Practice vol 10 no 4 pp 346ndash348 2007
[36] J E N Okonkwo and G O Udigwe ldquoMyomectomy in preg-nancyrdquo Journal of Obstetrics and Gynaecology vol 27 no 6 pp628ndash630 2007
[37] L Dracea and D Codreanu ldquoVaginal birth after extensivemyomectomy during pregnancy in a 39-year-old nulliparouswomanrdquo Journal of Obstetrics and Gynaecology vol 26 no 4pp 374ndash375 2006
[38] L Melgrati A Damiani G Franzoni M Marziali and FSesti ldquoIsobaric (gasless) laparoscopic myomectomy duringpregnancyrdquo Journal of Minimally Invasive Gynecology vol 12no 4 pp 379ndash381 2005
[39] L Sentilhes F Sergent E Verspyck A Gravier H Roman andL Marpeau ldquoLaparoscopic myomectomy during pregnancyresulting in septic necrosis of the myometriumrdquo BJOG AnInternational Journal of Obstetrics and Gynaecology vol 110 no9 pp 876ndash878 2003
[40] J Donnez C Pirard M Smets R Polet C Feger and JSquifflet ldquoUnusual growth of a myoma during pregnancyrdquoFertility and Sterility vol 78 no 3 pp 632ndash633 2002
[41] HWilliamson ldquoEnucleation during the seventh lunarmonth ofpregnancy of a uterine fibro-myomardquo Proceedings of the RoyalSociety of Medicine vol 1 pp 73ndash78 1908
[42] J Stewart ldquoEnucleation of fibro-myoma of uterus duringpregnancyrdquo British Medical Journal vol 1 no 2358 pp 548ndash549 1906
[43] A C Wittich E R Salminen M K Yancey and G RMarkenson ldquoMyomectomy during early pregnancyrdquo MilitaryMedicine vol 165 no 2 pp 162ndash164 2000
[44] M Majid G Q Khan and L MWei ldquoInevitable myomectomyin pregnancyrdquo Journal of Obstetrics and Gynaecology vol 17 no4 pp 377ndash378 1997
[45] A C Algara A G Rodrıguez A C Vazquez et al ldquoLaparo-scopic approach for fibroid removal at 18 weeks of pregnancyrdquoSurgical Technology International vol 27 pp 195ndash197 2015
[46] C Lockyer ldquoMultiple myomectomy in the sixth month ofpregnancy labour at termrdquo Proceedings of the Royal Society ofMedicine vol 7 pp 221ndash225 1914
[47] C A von Hoffmann ldquoAbdominal myomectomy during preg-nancyrdquoCalifornia State Journal ofMedicine vol 9 no 5 pp 197ndash200 1911
[48] H R Andrews ldquoMyomectomy during pregnancyrdquo Proceedingsof the Royal Society of Medicine vol 3 pp 164ndash166 1910
[49] WC Swayne ldquoAbdominal myomectomy during pregnancyrdquoProceedings of the Royal Society of Medicine vol 1 pp 129ndash1321908
[50] A Doran ldquoMyomectomy during pregnancy and labour at termin an elderly primipara with notes on similar casesrdquo BritishMedical Journal vol 2 no 2395 pp 1446ndash1447 1906
[51] H M Evans ldquoA case of myomectomy for subperitoneal myomacomplicating pregnancyrdquo British Medical Journal vol 2 no2033 p 1673 1899
[52] C Exacoustos and P Rosati ldquoUltrasound diagnosis of uterinemyomas and complications in pregnancyrdquoObstetrics and Gyne-cology vol 82 no 1 pp 97ndash101 1993
[53] C A Burton D A Grimes and C M March ldquoSurgicalmanagement of leiomyomata during pregnancyrdquoObstetrics andGynecology vol 74 no 5 pp 707ndash709 1989
[54] R Rella E Bonfadini Bossi and D Fagnani ldquoMyomectomy inpregnancy Description of an interesting clinical caserdquoMinervaGinecologica vol 32 no 4 pp 267ndash269 1980
[55] M A Pelosi M A Pelosi III and S Giblin ldquoLaparoscopicremoval of a 1500-g symptomatic myoma during the secondtrimester of pregnancyrdquo American Association of GynecologicLaparoscopists vol 2 no 4 pp 457ndash462 1995
[56] A Pelissier-Komorek J Hamm S Bonneau E Derniaux CHoeffel-Fornes and O Graesslin ldquoMyoma and pregnancywhen medical treatment is not sufficientrdquo Journal de Gynecolo-gie Obstetrique et Biologie de la Reproduction vol 41 no 3 pp307ndash310 2012
[57] G Mollica L Pittini E Minganti G Perri and F PansinildquoElective uterine myomectomy in pregnant womenrdquo Clinicaland Experimental Obstetrics and Gynecology vol 23 no 3 pp168ndash172 1996
[58] G Febo M Tessarolo L Leo S Arduino T Wierdis and LLanza ldquoSurgical management of leiomyomata in pregnancyrdquoClinical and ExperimentalObstetrics andGynecology vol 24 no2 pp 76ndash78 1997
[59] M Bonito L Gulemı R Basili and D Roselli ldquoMyomectomyduring the first and second trimester of pregnancyrdquoClinical andExperimental Obstetrics and Gynecology vol 34 no 3 pp 149ndash150 2007
[60] E E Vazquez Camacho E Cabrera Carranco and R GSanchez Herrera ldquoPedunculated twisted myoma and preg-nancy Case reportrdquoGinecologia y Obstetricia de Mexico vol 77no 9 pp 441ndash444 2009
[61] A P Makar E A Schatteman I B Vergote and E DesmedtldquoMyomectomy during pregnancy uncommon case reportrdquoActa Chirurgica Belgica vol 89 no 4 pp 212ndash214 1989
[62] R Horno Liria ldquoMyomectomy and pregnancyrdquo Rev Esp ObstetGinecol vol 19 pp 214ndash218 1962
[63] M C Alanis A Mitra and N Koklanaris ldquoPreoperativemagnetic resonance imaging and antepartummyomectomy of agiant pedunculated leiomyomardquoObstetrics and Gynecology vol111 no 2 part 2 pp 577ndash579 2008
Case Reports in Obstetrics and Gynecology 11
[64] G Ardizzone ldquoClinical and statistical considerations of 27cases of myomectomy in pregnancyrdquo Rivista di Ostetricia eGinecologia vol 10 no 12 pp 848ndash860 1955
[65] M Cozzi ldquoMyomectomy in pregnancyrdquo Quaderni di ClinicaOstetrica e Ginecologica vol 22 no 3 pp 171ndash180 1967
[66] Y Rochet M Cognat D Dargent and E Pollosson ldquoOnmyomectomy during pregnance (apropos of 14 observations)rdquoBulletin de la Federation des Societes de Gynecologie etDobstetrique de Langue Francaise vol 16 pp 462ndash463 1964
[67] F Sciannameo G Madami C Madami et al ldquoTorsion ofuterine fibroma associated with inguinal incarcerated hernia inpregnancy Case reportrdquo Minerva Ginecologica vol 48 no 11pp 501ndash504 1996
Submit your manuscripts athttpswwwhindawicom
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Diabetes ResearchJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
Case Reports in Obstetrics and Gynecology 9
Italiana di Medicina Perinatale SIMP) Naples (Italy) 19ndash21January 2017
Conflicts of Interest
The authors declare that there are no conflicts of interest
References
[1] S G Vitale A Tropea D Rossetti M Carnelli and A CiancildquoManagement of uterine leiomyomas in pregnancy review ofliteraturerdquo Updates in Surgery vol 65 no 3 pp 179ndash182 2013
[2] S K Sunkara M Khairy T El-Toukhy Y Khalaf and ACoomarasamy ldquoThe effect of intramural fibroids without uter-ine cavity involvement on the outcome of IVF treatment asystematic review and meta-analysisrdquo Human Reproductionvol 25 no 2 pp 418ndash429 2010
[3] V Lozza A Pieralli S Corioni M Longinotti and C PennaldquoMultiple laparotomic myomectomy during pregnancy a casereportrdquo Archives of Gynecology and Obstetrics vol 284 no 3pp 613ndash616 2011
[4] L Domenici V Di Donato M L Gasparri F Lecce J Caccettaand P B Panici ldquoLaparotomic myomectomy in the 16th weekof pregnancy a case reportrdquo Case Reports in Obstetrics andGynecology 5 pages 2014
[5] D E Lolis S N KalantaridouGMakrydimas et al ldquoSuccessfulmyomectomy during pregnancyrdquoHuman Reproduction vol 18no 8 pp 1699ndash1702 2003
[6] S De Carolis G Fatigante S Ferrazzani et al ldquoUterinemyomectomy in pregnant womenrdquo Fetal Diagnosis and Ther-apy vol 16 no 2 pp 116ndash119 2001
[7] N Bhatla B B Dash A Kriplani and N Agarwal ldquoMyomec-tomy during pregnancy a feasible optionrdquo Journal of Obstetricsand Gynaecology Research vol 35 no 1 pp 173ndash175 2009
[8] A Cagnacci D Pirillo S Malmusi S Arangino C Alessan-drini and A Volpe ldquoEarly outcome of myomectomy by laparo-tomy minilaparotomy and laparoscopically assisted minila-parotomy A randomized prospective studyrdquoHuman Reproduc-tion vol 18 no 12 pp 2590ndash2594 2003
[9] F Parazzini S Cipriani G Bulfoni et al ldquoCentiles of weightat term birth according to maternal nationality in a northernItalian regionrdquo Italian Journal of Gynaecology and Obstetricsvol 28 no 2 pp 52ndash56 2016
[10] S P Michalas F V Oreopoulou and J S PapageorgiouldquoMyomectomy during pregnancy and caesarean sectionrdquoHuman Reproduction vol 10 no 7 pp 1869ndash1870 1995
[11] E Danzer W Holzgreve C Batukan P Miny S Tercanli and IHoesli ldquoMyomectomy during the first trimester associated withfetal limb anomalies and hydrocephalus in a twin pregnancyrdquoPrenatal Diagnosis vol 21 no 10 pp 848ndash851 2001
[12] J G Joo J Inovay M Silhavy and Z Papp ldquoSuccessfulenucleation of a necrotizing fibroid causing oligohydramniosand fetal postural deformity in the 25th week of gestation Acase reportrdquo Journal of Reproductive Medicine vol 46 no 10pp 923ndash925 2001
[13] C Celik A Acar N Cicek K Gezginc and C Akyurek ldquoCanmyomectomy be performed during pregnancyrdquo Gynecologicand Obstetric Investigation vol 53 no 2 pp 79ndash83 2002
[14] U Hasbargen A Strauss M Summerer-Moustaki et alldquoMyomectomy as a pregnancy-preserving option in the care-fully selected patientrdquo Fetal Diagnosis and Therapy vol 17 no2 pp 101ndash103 2002
[15] C Umezurike and P Feyi-Waboso ldquoSuccessful myomectomyduring pregnancy a case reportrdquo Reproductive Health vol 2no 1 2005
[16] F Usifo R Macrae R Sharma I O Opemuyi and BOnwuzurike ldquoSuccessful myomectomy in early second trimes-ter of pregnancyrdquo Journal of Obstetrics and Gynaecology vol 27no 2 pp 196ndash197 2007
[17] F S Suwandinata S E Gruessner C O Omwandho and H RTinneberg ldquoPregnancy-preserving myomectomy preliminaryreport on a new surgical techniquerdquo European Journal ofContraception and Reproductive Health Care vol 13 no 3 pp323ndash326 2008 Erratum in European Journal of Contraceptionand Reproductive Health Care vol 13 no 4 article 438 2008
[18] G K Leite H A Korkes T Viana Ade A Pitorri G Kenj andN Sass ldquoMyomectomy in the second trimester of pregnancycase reportrdquo Revista Brasileira De Ginecologia E Obstetricia vol32 no 4 pp 198ndash201 2010
[19] P Isabu J Eigbefoh F Okogbo S Okunsanya and R EifediyildquoMyomectomy during second trimester pregnancy a casereportrdquo The Nigerian Postgraduate Medical Journal vol 17 no4 pp 324ndash326 2010
[20] K Leach L Khatain and K Tocce ldquoFirst trimester myomec-tomy as an alternative to termination of pregnancy in a womanwith a symptomatic uterine leiomyoma a case reportrdquo Journalof Medical Case Reports vol 5 article 571 2011
[21] S Doerga-Bachasingh V Karsdorp G Yo R Van Der Weidenand M Van Hooff ldquoSuccessful myomectomy of a bleedingmyoma in a twin pregnancyrdquo JRSM Short Reports vol 3 no 2article 13 2012
[22] P Jhalta S G Negi andV Sharma ldquoSuccessful myomectomy inearly pregnancy for a large asymptomatic uterine myoma casereportrdquo Pan African Medical Journal vol 13 no 24 article 228Article ID 228 2016
[23] C Kosmidis G Pantos C Efthimiadis I Gkoutziomitrou EGeorgakoudi and G Anthimidis ldquoLaparoscopic excision of apedunculated uterine leiomyoma in torsion as a cause of acuteabdomen at 10 weeks of pregnancyrdquo American Journal of CaseReports vol 16 pp 505ndash508 2015
[24] C Saccardi S Visentin M Noventa E Cosmi P Litta and SGizzo ldquoUncertainties about laparoscopic myomectomy duringpregnancy a lack of evidence or an inherited misconceptionA critical literature review starting from a peculiar caserdquoMinimally Invasive Therapy and Allied Technologies vol 24 no4 pp 189ndash194 2015
[25] M Obara Y Hatakeyama and Y Shimizu ldquoVaginal myomec-tomy for semipedunculated cervical myoma during pregnancyrdquoAmerican Journal of Perinatology Reports vol 4 no 1 pp 37ndash402014
[26] A Currie E Bradley M McEwen N Al-Shabibi and P DWillson ldquoLaparoscopic approach to fibroid torsion presentingas an acute abdomen in pregnancyrdquo Journal of the Society ofLaparoendoscopic Surgeons vol 17 no 4 pp 665ndash667 2013
[27] F Kobayashi E Kondoh J Hamanishi Y Kawamura KTatsumi and I Konishi ldquoPyomayoma during pregnancy a casereport and review of the literaturerdquo Journal of Obstetrics andGynaecology Research vol 39 no 1 pp 383ndash389 2013
[28] A MacCio C Madeddu P Kotsonis et al ldquoThree cases oflaparoscopic myomectomy performed during pregnancy for
10 Case Reports in Obstetrics and Gynecology
pedunculated uterine myomasrdquo Archives of Gynecology andObstetrics vol 286 no 5 pp 1209ndash1214 2012
[29] M Shafiee M Nor Azlin and D Arifuddin ldquoA successfulantenatal myomectomyrdquo Malaysian Family Physician vol 31no 7(2-3) pp 42ndash45 2012
[30] M Ardovino I Ardovino M A Castaldi A Monteverde NColacurci and L Cobellis ldquoLaparoscopic myomectomy of asubserous pedunculated fibroid at 14 weeks of pregnancy a casereportrdquo Journal of Medical Case Reports vol 5 article 545 2011
[31] A Muller Vranjes S Sijanovic D Vidosavljevic Z Kasac andK Abicic Zuljevic ldquoSurgical treatment of large smooth muscletumor of uncertain malignant potential during pregnancyrdquoMedicinski Glasnik Journal vol 8 no 2 pp 290ndash292 2011
[32] C E Son J S Choi J H Lee S W Jeon J W Bae and S SSeo ldquoA case of laparoscopic myomectomy performed duringpregnancy for subserosal uterine myomardquo Journal of Obstetricsand Gynaecology vol 31 no 2 pp 180ndash181 2011
[33] M Kasum ldquoHemoperitoneum caused by a bleeding myoma inpregnancyrdquo Acta Clinica Croatica vol 49 no 2 pp 197ndash2002010
[34] F Fanfani C Rossitto A Fagotti P Rosati V Gallotta andG Scambia ldquoLaparoscopic myomectomy at 25 weeks of preg-nancy case reportrdquo Journal of Minimally Invasive Gynecologyvol 17 no 1 pp 91ndash93 2010
[35] A S Adeyemi S E Akinola and A I Isawumi ldquoAntepartummyomectomywith a live term deliverymdasha case reportrdquoNigerianJournal of Clinical Practice vol 10 no 4 pp 346ndash348 2007
[36] J E N Okonkwo and G O Udigwe ldquoMyomectomy in preg-nancyrdquo Journal of Obstetrics and Gynaecology vol 27 no 6 pp628ndash630 2007
[37] L Dracea and D Codreanu ldquoVaginal birth after extensivemyomectomy during pregnancy in a 39-year-old nulliparouswomanrdquo Journal of Obstetrics and Gynaecology vol 26 no 4pp 374ndash375 2006
[38] L Melgrati A Damiani G Franzoni M Marziali and FSesti ldquoIsobaric (gasless) laparoscopic myomectomy duringpregnancyrdquo Journal of Minimally Invasive Gynecology vol 12no 4 pp 379ndash381 2005
[39] L Sentilhes F Sergent E Verspyck A Gravier H Roman andL Marpeau ldquoLaparoscopic myomectomy during pregnancyresulting in septic necrosis of the myometriumrdquo BJOG AnInternational Journal of Obstetrics and Gynaecology vol 110 no9 pp 876ndash878 2003
[40] J Donnez C Pirard M Smets R Polet C Feger and JSquifflet ldquoUnusual growth of a myoma during pregnancyrdquoFertility and Sterility vol 78 no 3 pp 632ndash633 2002
[41] HWilliamson ldquoEnucleation during the seventh lunarmonth ofpregnancy of a uterine fibro-myomardquo Proceedings of the RoyalSociety of Medicine vol 1 pp 73ndash78 1908
[42] J Stewart ldquoEnucleation of fibro-myoma of uterus duringpregnancyrdquo British Medical Journal vol 1 no 2358 pp 548ndash549 1906
[43] A C Wittich E R Salminen M K Yancey and G RMarkenson ldquoMyomectomy during early pregnancyrdquo MilitaryMedicine vol 165 no 2 pp 162ndash164 2000
[44] M Majid G Q Khan and L MWei ldquoInevitable myomectomyin pregnancyrdquo Journal of Obstetrics and Gynaecology vol 17 no4 pp 377ndash378 1997
[45] A C Algara A G Rodrıguez A C Vazquez et al ldquoLaparo-scopic approach for fibroid removal at 18 weeks of pregnancyrdquoSurgical Technology International vol 27 pp 195ndash197 2015
[46] C Lockyer ldquoMultiple myomectomy in the sixth month ofpregnancy labour at termrdquo Proceedings of the Royal Society ofMedicine vol 7 pp 221ndash225 1914
[47] C A von Hoffmann ldquoAbdominal myomectomy during preg-nancyrdquoCalifornia State Journal ofMedicine vol 9 no 5 pp 197ndash200 1911
[48] H R Andrews ldquoMyomectomy during pregnancyrdquo Proceedingsof the Royal Society of Medicine vol 3 pp 164ndash166 1910
[49] WC Swayne ldquoAbdominal myomectomy during pregnancyrdquoProceedings of the Royal Society of Medicine vol 1 pp 129ndash1321908
[50] A Doran ldquoMyomectomy during pregnancy and labour at termin an elderly primipara with notes on similar casesrdquo BritishMedical Journal vol 2 no 2395 pp 1446ndash1447 1906
[51] H M Evans ldquoA case of myomectomy for subperitoneal myomacomplicating pregnancyrdquo British Medical Journal vol 2 no2033 p 1673 1899
[52] C Exacoustos and P Rosati ldquoUltrasound diagnosis of uterinemyomas and complications in pregnancyrdquoObstetrics and Gyne-cology vol 82 no 1 pp 97ndash101 1993
[53] C A Burton D A Grimes and C M March ldquoSurgicalmanagement of leiomyomata during pregnancyrdquoObstetrics andGynecology vol 74 no 5 pp 707ndash709 1989
[54] R Rella E Bonfadini Bossi and D Fagnani ldquoMyomectomy inpregnancy Description of an interesting clinical caserdquoMinervaGinecologica vol 32 no 4 pp 267ndash269 1980
[55] M A Pelosi M A Pelosi III and S Giblin ldquoLaparoscopicremoval of a 1500-g symptomatic myoma during the secondtrimester of pregnancyrdquo American Association of GynecologicLaparoscopists vol 2 no 4 pp 457ndash462 1995
[56] A Pelissier-Komorek J Hamm S Bonneau E Derniaux CHoeffel-Fornes and O Graesslin ldquoMyoma and pregnancywhen medical treatment is not sufficientrdquo Journal de Gynecolo-gie Obstetrique et Biologie de la Reproduction vol 41 no 3 pp307ndash310 2012
[57] G Mollica L Pittini E Minganti G Perri and F PansinildquoElective uterine myomectomy in pregnant womenrdquo Clinicaland Experimental Obstetrics and Gynecology vol 23 no 3 pp168ndash172 1996
[58] G Febo M Tessarolo L Leo S Arduino T Wierdis and LLanza ldquoSurgical management of leiomyomata in pregnancyrdquoClinical and ExperimentalObstetrics andGynecology vol 24 no2 pp 76ndash78 1997
[59] M Bonito L Gulemı R Basili and D Roselli ldquoMyomectomyduring the first and second trimester of pregnancyrdquoClinical andExperimental Obstetrics and Gynecology vol 34 no 3 pp 149ndash150 2007
[60] E E Vazquez Camacho E Cabrera Carranco and R GSanchez Herrera ldquoPedunculated twisted myoma and preg-nancy Case reportrdquoGinecologia y Obstetricia de Mexico vol 77no 9 pp 441ndash444 2009
[61] A P Makar E A Schatteman I B Vergote and E DesmedtldquoMyomectomy during pregnancy uncommon case reportrdquoActa Chirurgica Belgica vol 89 no 4 pp 212ndash214 1989
[62] R Horno Liria ldquoMyomectomy and pregnancyrdquo Rev Esp ObstetGinecol vol 19 pp 214ndash218 1962
[63] M C Alanis A Mitra and N Koklanaris ldquoPreoperativemagnetic resonance imaging and antepartummyomectomy of agiant pedunculated leiomyomardquoObstetrics and Gynecology vol111 no 2 part 2 pp 577ndash579 2008
Case Reports in Obstetrics and Gynecology 11
[64] G Ardizzone ldquoClinical and statistical considerations of 27cases of myomectomy in pregnancyrdquo Rivista di Ostetricia eGinecologia vol 10 no 12 pp 848ndash860 1955
[65] M Cozzi ldquoMyomectomy in pregnancyrdquo Quaderni di ClinicaOstetrica e Ginecologica vol 22 no 3 pp 171ndash180 1967
[66] Y Rochet M Cognat D Dargent and E Pollosson ldquoOnmyomectomy during pregnance (apropos of 14 observations)rdquoBulletin de la Federation des Societes de Gynecologie etDobstetrique de Langue Francaise vol 16 pp 462ndash463 1964
[67] F Sciannameo G Madami C Madami et al ldquoTorsion ofuterine fibroma associated with inguinal incarcerated hernia inpregnancy Case reportrdquo Minerva Ginecologica vol 48 no 11pp 501ndash504 1996
Submit your manuscripts athttpswwwhindawicom
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Diabetes ResearchJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
10 Case Reports in Obstetrics and Gynecology
pedunculated uterine myomasrdquo Archives of Gynecology andObstetrics vol 286 no 5 pp 1209ndash1214 2012
[29] M Shafiee M Nor Azlin and D Arifuddin ldquoA successfulantenatal myomectomyrdquo Malaysian Family Physician vol 31no 7(2-3) pp 42ndash45 2012
[30] M Ardovino I Ardovino M A Castaldi A Monteverde NColacurci and L Cobellis ldquoLaparoscopic myomectomy of asubserous pedunculated fibroid at 14 weeks of pregnancy a casereportrdquo Journal of Medical Case Reports vol 5 article 545 2011
[31] A Muller Vranjes S Sijanovic D Vidosavljevic Z Kasac andK Abicic Zuljevic ldquoSurgical treatment of large smooth muscletumor of uncertain malignant potential during pregnancyrdquoMedicinski Glasnik Journal vol 8 no 2 pp 290ndash292 2011
[32] C E Son J S Choi J H Lee S W Jeon J W Bae and S SSeo ldquoA case of laparoscopic myomectomy performed duringpregnancy for subserosal uterine myomardquo Journal of Obstetricsand Gynaecology vol 31 no 2 pp 180ndash181 2011
[33] M Kasum ldquoHemoperitoneum caused by a bleeding myoma inpregnancyrdquo Acta Clinica Croatica vol 49 no 2 pp 197ndash2002010
[34] F Fanfani C Rossitto A Fagotti P Rosati V Gallotta andG Scambia ldquoLaparoscopic myomectomy at 25 weeks of preg-nancy case reportrdquo Journal of Minimally Invasive Gynecologyvol 17 no 1 pp 91ndash93 2010
[35] A S Adeyemi S E Akinola and A I Isawumi ldquoAntepartummyomectomywith a live term deliverymdasha case reportrdquoNigerianJournal of Clinical Practice vol 10 no 4 pp 346ndash348 2007
[36] J E N Okonkwo and G O Udigwe ldquoMyomectomy in preg-nancyrdquo Journal of Obstetrics and Gynaecology vol 27 no 6 pp628ndash630 2007
[37] L Dracea and D Codreanu ldquoVaginal birth after extensivemyomectomy during pregnancy in a 39-year-old nulliparouswomanrdquo Journal of Obstetrics and Gynaecology vol 26 no 4pp 374ndash375 2006
[38] L Melgrati A Damiani G Franzoni M Marziali and FSesti ldquoIsobaric (gasless) laparoscopic myomectomy duringpregnancyrdquo Journal of Minimally Invasive Gynecology vol 12no 4 pp 379ndash381 2005
[39] L Sentilhes F Sergent E Verspyck A Gravier H Roman andL Marpeau ldquoLaparoscopic myomectomy during pregnancyresulting in septic necrosis of the myometriumrdquo BJOG AnInternational Journal of Obstetrics and Gynaecology vol 110 no9 pp 876ndash878 2003
[40] J Donnez C Pirard M Smets R Polet C Feger and JSquifflet ldquoUnusual growth of a myoma during pregnancyrdquoFertility and Sterility vol 78 no 3 pp 632ndash633 2002
[41] HWilliamson ldquoEnucleation during the seventh lunarmonth ofpregnancy of a uterine fibro-myomardquo Proceedings of the RoyalSociety of Medicine vol 1 pp 73ndash78 1908
[42] J Stewart ldquoEnucleation of fibro-myoma of uterus duringpregnancyrdquo British Medical Journal vol 1 no 2358 pp 548ndash549 1906
[43] A C Wittich E R Salminen M K Yancey and G RMarkenson ldquoMyomectomy during early pregnancyrdquo MilitaryMedicine vol 165 no 2 pp 162ndash164 2000
[44] M Majid G Q Khan and L MWei ldquoInevitable myomectomyin pregnancyrdquo Journal of Obstetrics and Gynaecology vol 17 no4 pp 377ndash378 1997
[45] A C Algara A G Rodrıguez A C Vazquez et al ldquoLaparo-scopic approach for fibroid removal at 18 weeks of pregnancyrdquoSurgical Technology International vol 27 pp 195ndash197 2015
[46] C Lockyer ldquoMultiple myomectomy in the sixth month ofpregnancy labour at termrdquo Proceedings of the Royal Society ofMedicine vol 7 pp 221ndash225 1914
[47] C A von Hoffmann ldquoAbdominal myomectomy during preg-nancyrdquoCalifornia State Journal ofMedicine vol 9 no 5 pp 197ndash200 1911
[48] H R Andrews ldquoMyomectomy during pregnancyrdquo Proceedingsof the Royal Society of Medicine vol 3 pp 164ndash166 1910
[49] WC Swayne ldquoAbdominal myomectomy during pregnancyrdquoProceedings of the Royal Society of Medicine vol 1 pp 129ndash1321908
[50] A Doran ldquoMyomectomy during pregnancy and labour at termin an elderly primipara with notes on similar casesrdquo BritishMedical Journal vol 2 no 2395 pp 1446ndash1447 1906
[51] H M Evans ldquoA case of myomectomy for subperitoneal myomacomplicating pregnancyrdquo British Medical Journal vol 2 no2033 p 1673 1899
[52] C Exacoustos and P Rosati ldquoUltrasound diagnosis of uterinemyomas and complications in pregnancyrdquoObstetrics and Gyne-cology vol 82 no 1 pp 97ndash101 1993
[53] C A Burton D A Grimes and C M March ldquoSurgicalmanagement of leiomyomata during pregnancyrdquoObstetrics andGynecology vol 74 no 5 pp 707ndash709 1989
[54] R Rella E Bonfadini Bossi and D Fagnani ldquoMyomectomy inpregnancy Description of an interesting clinical caserdquoMinervaGinecologica vol 32 no 4 pp 267ndash269 1980
[55] M A Pelosi M A Pelosi III and S Giblin ldquoLaparoscopicremoval of a 1500-g symptomatic myoma during the secondtrimester of pregnancyrdquo American Association of GynecologicLaparoscopists vol 2 no 4 pp 457ndash462 1995
[56] A Pelissier-Komorek J Hamm S Bonneau E Derniaux CHoeffel-Fornes and O Graesslin ldquoMyoma and pregnancywhen medical treatment is not sufficientrdquo Journal de Gynecolo-gie Obstetrique et Biologie de la Reproduction vol 41 no 3 pp307ndash310 2012
[57] G Mollica L Pittini E Minganti G Perri and F PansinildquoElective uterine myomectomy in pregnant womenrdquo Clinicaland Experimental Obstetrics and Gynecology vol 23 no 3 pp168ndash172 1996
[58] G Febo M Tessarolo L Leo S Arduino T Wierdis and LLanza ldquoSurgical management of leiomyomata in pregnancyrdquoClinical and ExperimentalObstetrics andGynecology vol 24 no2 pp 76ndash78 1997
[59] M Bonito L Gulemı R Basili and D Roselli ldquoMyomectomyduring the first and second trimester of pregnancyrdquoClinical andExperimental Obstetrics and Gynecology vol 34 no 3 pp 149ndash150 2007
[60] E E Vazquez Camacho E Cabrera Carranco and R GSanchez Herrera ldquoPedunculated twisted myoma and preg-nancy Case reportrdquoGinecologia y Obstetricia de Mexico vol 77no 9 pp 441ndash444 2009
[61] A P Makar E A Schatteman I B Vergote and E DesmedtldquoMyomectomy during pregnancy uncommon case reportrdquoActa Chirurgica Belgica vol 89 no 4 pp 212ndash214 1989
[62] R Horno Liria ldquoMyomectomy and pregnancyrdquo Rev Esp ObstetGinecol vol 19 pp 214ndash218 1962
[63] M C Alanis A Mitra and N Koklanaris ldquoPreoperativemagnetic resonance imaging and antepartummyomectomy of agiant pedunculated leiomyomardquoObstetrics and Gynecology vol111 no 2 part 2 pp 577ndash579 2008
Case Reports in Obstetrics and Gynecology 11
[64] G Ardizzone ldquoClinical and statistical considerations of 27cases of myomectomy in pregnancyrdquo Rivista di Ostetricia eGinecologia vol 10 no 12 pp 848ndash860 1955
[65] M Cozzi ldquoMyomectomy in pregnancyrdquo Quaderni di ClinicaOstetrica e Ginecologica vol 22 no 3 pp 171ndash180 1967
[66] Y Rochet M Cognat D Dargent and E Pollosson ldquoOnmyomectomy during pregnance (apropos of 14 observations)rdquoBulletin de la Federation des Societes de Gynecologie etDobstetrique de Langue Francaise vol 16 pp 462ndash463 1964
[67] F Sciannameo G Madami C Madami et al ldquoTorsion ofuterine fibroma associated with inguinal incarcerated hernia inpregnancy Case reportrdquo Minerva Ginecologica vol 48 no 11pp 501ndash504 1996
Submit your manuscripts athttpswwwhindawicom
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Diabetes ResearchJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
Case Reports in Obstetrics and Gynecology 11
[64] G Ardizzone ldquoClinical and statistical considerations of 27cases of myomectomy in pregnancyrdquo Rivista di Ostetricia eGinecologia vol 10 no 12 pp 848ndash860 1955
[65] M Cozzi ldquoMyomectomy in pregnancyrdquo Quaderni di ClinicaOstetrica e Ginecologica vol 22 no 3 pp 171ndash180 1967
[66] Y Rochet M Cognat D Dargent and E Pollosson ldquoOnmyomectomy during pregnance (apropos of 14 observations)rdquoBulletin de la Federation des Societes de Gynecologie etDobstetrique de Langue Francaise vol 16 pp 462ndash463 1964
[67] F Sciannameo G Madami C Madami et al ldquoTorsion ofuterine fibroma associated with inguinal incarcerated hernia inpregnancy Case reportrdquo Minerva Ginecologica vol 48 no 11pp 501ndash504 1996
Submit your manuscripts athttpswwwhindawicom
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Diabetes ResearchJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom
Submit your manuscripts athttpswwwhindawicom
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Disease Markers
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Diabetes ResearchJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Research and TreatmentAIDS
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Parkinsonrsquos Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom