Full-term delivery after antepartum vaginal myomectomy for prolapsed myoma causing uterus distortion: A case report and literature review

Abstract

Objective: Prolapsed cervical myoma with uterine distortion during pregnancy are rare. Case presentation: A 45-year-old woman at 30 weeks of gestation presented with a prolapsed mass and vaginal fluid leakage. A 9 x 8 x 8 cm3 prolapsed mass was observed outside the vaginal orifice, and preterm premature rupture of membranes (PPROM) was suspected. Transabdominal ultrasonography revealed an elongated cervix. Magnetic resonance imaging (MRI) indicated a cervical myoma causing mechanical pulling of the amniotic membrane, resulting in cervical elongation. The patient underwent antepartum vaginal myomectomy and manual reduction of uterine prolapse, which led to spontaneous resolution of PPROM. The subsequent pregnancy course was unremarkable. Conclusions: Prolapsed myoma with uterine distortion during pregnancy are extremely rare. Antepartum vaginal myomectomy should be considered with caution to reduce the risk of preterm births.