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.