Case Presentation:
A 36-year-old female at 40 weeks and 2 days of gestation was admitted to
labor and delivery for labor management. A 30-week growth ultrasound
showed normal fetal anatomy and growth as well as a large uterine
fibroid on the anterior left lateral wall measuring 9.2cm x 8.2xm x 5.7
cm (Figure 1). The fibroid had not been seen on prior ultrasounds at 15
and 22 weeks.
During labor, the patient progressed to 8 cm of cervical dilation. After
6 hours of adequate uterine contractions there was no further cervical
dilation with repeat cervical exam revealing the left side of the cervix
being swollen and edematous compared to the right side. A primary
cesarean section was recommended secondary to arrest of labor and
failure to dilate.
After delivery of the newborn via cesarean section, the uterus was
exteriorized and noted to have large 9cmx8cmx5cm mass on the left
anterior lateral wall of the uterus (Figure 2). The rest of the uterus,
ovaries, and fallopian tubes were unremarkable. The patient tolerated
the procedure well without complications and was discharged from the
hospital on post operative day two in stable condition with the plan for
a pelvic US at 6 weeks postpartum visit.