Myomectomy, the surgical removal of fibroids, is rarely performed during pregnancy because it poses significant risks to both the mother and the fetus. Operating on a pregnant uterus can result in heavy bleeding, miscarriage, or preterm labor. Research shows that fibroids affect about 2–4% of all pregnancies, but less than 0.5% require surgical intervention. In most cases, doctors manage fibroids conservatively until after delivery—unless they cause severe pain, rapid growth, or life-threatening complications.
Despite these risks, in rare and carefully selected cases, a myomectomy during pregnancy becomes both necessary and life-saving.
A Rare Success Story at Motherhood Hospital
In a remarkable demonstration of clinical expertise, Dr. Mansi Sharma, Obstetrician & Gynaecologist at Motherhood Hospital, Kharadi, led a medical team through a complex case involving a large uterine fibroid during pregnancy. At 37 weeks, the team carried out a planned cesarean section combined with a myomectomy—a rare procedure due to its bleeding risks. The surgery went smoothly, resulting in the safe birth of a healthy baby and the successful removal of the fibroid. This case emphasized the importance of antenatal checkups, early diagnosis, expert clinical judgment, and personalized care in managing high-risk pregnancies.
The Patient’s Journey
Radhika Kamra (name changed), a working professional in her early 30s, came for a routine antenatal check-up with Dr. Mansi Sharma. During her ultrasound, doctors discovered a significant intramural fibroid measuring 8 cm—roughly the size of a small melon—along with multiple smaller fibroids measuring 1–2 cm. Fibroids occur in 0.8–10% of pregnancies, depending on population and diagnostic methods.
Although Radhika’s pregnancy progressed without major complications like intrauterine growth restriction (IUGR), fetal malpresentation, or preterm labor, she experienced intermittent abdominal pain. This pain stemmed from fibroid degeneration, a condition in which the fibroid outgrows its blood supply, leading to tissue breakdown, inflammation, and discomfort.
Expert Insights on Managing Fibroids During Pregnancy
Explaining the case, Dr. Mansi Sharma said,
“A myoma, or uterine fibroid, is a non-cancerous growth in or around the uterus, often influenced by hormonal changes. While common in reproductive-age women, large fibroids during pregnancy can cause complications such as pain, fetal malposition, or delivery difficulties. Surgery is usually avoided due to the risk of heavy bleeding, but in select cases, a cesarean myomectomy may be necessary to ensure safe delivery for both mother and baby.”
Why Surgery Became Necessary
By the third trimester, Radhika’s large fibroid caused cephalo-pelvic disproportion—the baby’s head could not descend into the pelvis because the fibroid blocked the way. This obstruction necessitated a planned elective cesarean section at 37 weeks. During the procedure, the obstetric team not only delivered the baby safely but also removed the 8 cm fibroid in a well-executed cesarean myomectomy.
Dr. Sharma shared,
“The procedure was uneventful, with no breach in the uterine cavity or need for blood transfusion. The smaller fibroids, influenced by pregnancy hormones, were left untouched since they typically shrink after childbirth.”
A Healthy Outcome for Mother and Baby
As per the press release, Radhika had a full-term delivery, and both she and her baby recovered well. Doctors expect the smaller fibroids to regress naturally postpartum.This case highlights the critical role of regular antenatal checkups, timely diagnosis, and individualized care in managing high-risk pregnancies. Cesarean myomectomy, though rare, can be a necessary intervention when fibroids significantly affect delivery outcomes.
The Patient’s Gratitude
Reflecting on her experience, Radhika said,
“I’m truly grateful to Dr. Mansi Sharma for giving me the safest delivery I could have hoped for. Despite the fibroid, she ensured my baby was born healthy, and I came out of surgery without complications. Her constant support and expert care made all the difference.”