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Outcome of Myomectomy for Urinary Complications During the Second Trimenon of Pregnancy: 2 Cases Reports at the University Teaching Hospital of Angre / Abidjan

Received: 14 July 2021    Accepted: 24 July 2021    Published: 2 August 2021
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Abstract

Uterine myomas are observed in about 3-12% of pregnant women. These uterine fibroids can affect the outcome of pregnancy. There is an increased risk of spontaneous abortion, irregular fetal presentation, aseptic necrosis, placenta previa, premature birth, caesarean section, peripartum hemorrhage and also compression of nearby organs. Although myomectomy during pregnancy is not recommended, some emergency situations lead to retain this surgical indication. The authors report 2 cases of voluminous uterine myomas (FIGO type VI) that caused mechanical compression of the urinary tract with ureterohydronephrosis during the second trimenon of pregnancy. In our first clinical observation, the presence of fibroid was associated with severe bilateral ureterohydronephrosis, myomectomy was essential before the evolutionary risk towards renal failure. In our reported second case, there was no pain but acute retention of urine that required bladder catheterization. This retention was associated with sub-occlusive symptoms with stopping the materials for two weeks without gas. They benefited from a laparotomic myomectomy before term, with a favourable outcome for the mother and the child. The myomectomy during pregnancy remains exceptional and the evolutionary modalities are unpredictable with an increased risk of haemorrhage which can darken the obstetric prognosis, or even the vital one of the mother-child couple. Close prenatal monitoring is still necessary after the myomectomy.

Published in Journal of Gynecology and Obstetrics (Volume 9, Issue 4)
DOI 10.11648/j.jgo.20210904.13
Page(s) 112-115
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Myomectomy, Pregnancy, Ureterohydronephrosis, Prognosis

References
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[2] Levast F, Legendre G, Bouet PE, Sentilhes L. Prise en charge des myomes utérins pendant la grossesse. Gynecol Obstet Fertil. 2016 Juin; 44 (6): 350-4. Doi: 10.1016/j. gyobfe.2016.04.007. PMID: 27216952.
[3] Chauveaud-Lambling A, Fernandez H. Fibrome et grossesse. EMC-gynécologie obstétrique 2004; 5-047-R-10.
[4] Spyropoulou K, Kosmas I, Tsakiridis I, Mamopoulos A, Kalogiannidis I, Athanasiadis A, Daponte A, Dagklis T. Myomectomie pendant la grossesse: une revue systématique. Eur J Obstet Gynecol Reprod Biol. 2020 novembre; 254: 15-24. doi: 10.1016/j.ejogrb.2020.08.018. PMID: 32919229.
[5] Celik C, Acar A, Nedim C, Kazim G, Cemalettin A. (2002) La myomectomie peut-elle être pratiquée pendant la grossesse ? Gynecol Obstet Invest 53: 79-83.
[6] Lopes P, Thibaud S, Simonnet R et al. Fibromes et grossesse: quels sont les risques ? J Gynecol Obstet Biol Reprod 1999; 28: 772–77.
[7] Karlsen K, Schiøler Kesmodel U, Mogensen O, Humaidan P, Ravn P. Relation entre un diagnostic de fibrome utérin et le risque de résultats obstétricaux indésirables: une étude de cohorte. BMJ Open. 17 février 2020; 10 (2): e032104. Doi: 10.1136/bmjopen-2019-032104.PMID: 32071172.
[8] Gávai M, Hupuczi P, Papp Z. Abdominal myomectomy as an alternative to hysterectomy: analysis of 504 cases, Orv Hetil. 2006 May 28; 147, 21: 971-8.
[9] Suwandinata FS, Gruessner SE, Omwandho CO, Tinneberg HR. Myomectomie préservant la grossesse: rapport préliminaire sur une nouvelle technique chirurgicale. The European Journal of Contraception & Reproductive Health Care. 1 janvier 2008; 13 (3): 323–6.
[10] Lolis DE, Kalantaridou SN, Makrydimas G, Sotiriadis A, Navrozoglou I, Zikopoulos K, Paraskevaidis EA. Myomectomie réussie pendant la grossesse. Reproduction humaine. 1 août 2003; 18 (8): 1699-1702.
[11] Carolis SD, Fatigante G, Ferrazzani S, Trivellini C, Santis LD, et al. (2011) Myomectomie utérine chez les femmes enceintes. Diagnostic fœtal Ther 16: 116-9.
[12] Farshad T, F, Morje M, Hurrell A, Gallaher C, Dawlatly B (2018) Myomectomie réussie au deuxième trimestre chez une patiente gravement malade. Crit Care Obst Gyne. Vol. 4 n° 2: 5. doi: 10.21767/2471-9803.1000158.
[13] Barinov SV, Tirskaya YI, Lazareva OV, Kadcyna TV, Shamina IV, Medyannikova IV, Borisova AV, Frikel EA, Beznoshchenko GB. Pregnancy outcomes in women with large uterine fibroids. Journal of Maternal-Fetal and Neonatal Medicine, 2021; doi.org/10.1080/14767058.2021.1879044.
[14] Ezzedine D, Norwitz ER. Clin Obstet Gynecol. Les femmes atteintes de fibromes utérins présentent-elles un risque accru d'issue défavorable de la grossesse? 2016 mars; 59 (1): 119-27. Doi: 10.1097/GRF.0000000000000169. PMID: 26670833.
[15] Metwally M, Cheong YC, Horne AW. Traitement chirurgical des fibromes pour l'hypofertilité. Base de données Cochrane, Rev., 14 novembre 2012; 11: CD003857. Doi: 10.1002/14651858.CD003857.pub3. PMID: 23152222.
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Cite This Article
  • APA Style

    Koffi Soh Victor, Adjoby Roland, Effoh Ndrin Denis, Kouakou-Kouraogo Ramata, Akobé Privat, et al. (2021). Outcome of Myomectomy for Urinary Complications During the Second Trimenon of Pregnancy: 2 Cases Reports at the University Teaching Hospital of Angre / Abidjan. Journal of Gynecology and Obstetrics, 9(4), 112-115. https://doi.org/10.11648/j.jgo.20210904.13

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    ACS Style

    Koffi Soh Victor; Adjoby Roland; Effoh Ndrin Denis; Kouakou-Kouraogo Ramata; Akobé Privat, et al. Outcome of Myomectomy for Urinary Complications During the Second Trimenon of Pregnancy: 2 Cases Reports at the University Teaching Hospital of Angre / Abidjan. J. Gynecol. Obstet. 2021, 9(4), 112-115. doi: 10.11648/j.jgo.20210904.13

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    AMA Style

    Koffi Soh Victor, Adjoby Roland, Effoh Ndrin Denis, Kouakou-Kouraogo Ramata, Akobé Privat, et al. Outcome of Myomectomy for Urinary Complications During the Second Trimenon of Pregnancy: 2 Cases Reports at the University Teaching Hospital of Angre / Abidjan. J Gynecol Obstet. 2021;9(4):112-115. doi: 10.11648/j.jgo.20210904.13

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  • @article{10.11648/j.jgo.20210904.13,
      author = {Koffi Soh Victor and Adjoby Roland and Effoh Ndrin Denis and Kouakou-Kouraogo Ramata and Akobé Privat and Soumahoro Zingbe Gondo and Loba Okoin Paul José and Gbary-Lagaud Eléonore},
      title = {Outcome of Myomectomy for Urinary Complications During the Second Trimenon of Pregnancy: 2 Cases Reports at the University Teaching Hospital of Angre / Abidjan},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {9},
      number = {4},
      pages = {112-115},
      doi = {10.11648/j.jgo.20210904.13},
      url = {https://doi.org/10.11648/j.jgo.20210904.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20210904.13},
      abstract = {Uterine myomas are observed in about 3-12% of pregnant women. These uterine fibroids can affect the outcome of pregnancy. There is an increased risk of spontaneous abortion, irregular fetal presentation, aseptic necrosis, placenta previa, premature birth, caesarean section, peripartum hemorrhage and also compression of nearby organs. Although myomectomy during pregnancy is not recommended, some emergency situations lead to retain this surgical indication. The authors report 2 cases of voluminous uterine myomas (FIGO type VI) that caused mechanical compression of the urinary tract with ureterohydronephrosis during the second trimenon of pregnancy. In our first clinical observation, the presence of fibroid was associated with severe bilateral ureterohydronephrosis, myomectomy was essential before the evolutionary risk towards renal failure. In our reported second case, there was no pain but acute retention of urine that required bladder catheterization. This retention was associated with sub-occlusive symptoms with stopping the materials for two weeks without gas. They benefited from a laparotomic myomectomy before term, with a favourable outcome for the mother and the child. The myomectomy during pregnancy remains exceptional and the evolutionary modalities are unpredictable with an increased risk of haemorrhage which can darken the obstetric prognosis, or even the vital one of the mother-child couple. Close prenatal monitoring is still necessary after the myomectomy.},
     year = {2021}
    }
    

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    AU  - Koffi Soh Victor
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    AU  - Effoh Ndrin Denis
    AU  - Kouakou-Kouraogo Ramata
    AU  - Akobé Privat
    AU  - Soumahoro Zingbe Gondo
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    JF  - Journal of Gynecology and Obstetrics
    JO  - Journal of Gynecology and Obstetrics
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    AB  - Uterine myomas are observed in about 3-12% of pregnant women. These uterine fibroids can affect the outcome of pregnancy. There is an increased risk of spontaneous abortion, irregular fetal presentation, aseptic necrosis, placenta previa, premature birth, caesarean section, peripartum hemorrhage and also compression of nearby organs. Although myomectomy during pregnancy is not recommended, some emergency situations lead to retain this surgical indication. The authors report 2 cases of voluminous uterine myomas (FIGO type VI) that caused mechanical compression of the urinary tract with ureterohydronephrosis during the second trimenon of pregnancy. In our first clinical observation, the presence of fibroid was associated with severe bilateral ureterohydronephrosis, myomectomy was essential before the evolutionary risk towards renal failure. In our reported second case, there was no pain but acute retention of urine that required bladder catheterization. This retention was associated with sub-occlusive symptoms with stopping the materials for two weeks without gas. They benefited from a laparotomic myomectomy before term, with a favourable outcome for the mother and the child. The myomectomy during pregnancy remains exceptional and the evolutionary modalities are unpredictable with an increased risk of haemorrhage which can darken the obstetric prognosis, or even the vital one of the mother-child couple. Close prenatal monitoring is still necessary after the myomectomy.
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Author Information
  • Teaching Hospital Center of Angre, Mother and Child Department, Felix Houphouet Boigny University, Abidjan, Cote d’Ivoire

  • Teaching Hospital Center of Angre, Mother and Child Department, Felix Houphouet Boigny University, Abidjan, Cote d’Ivoire

  • Teaching Hospital Center of Angre, Mother and Child Department, Felix Houphouet Boigny University, Abidjan, Cote d’Ivoire

  • Teaching Hospital Center of Angre, Mother and Child Department, Felix Houphouet Boigny University, Abidjan, Cote d’Ivoire

  • Teaching Hospital Center of Angre, Mother and Child Department, Felix Houphouet Boigny University, Abidjan, Cote d’Ivoire

  • Teaching Hospital Center of Angre, Mother and Child Department, Felix Houphouet Boigny University, Abidjan, Cote d’Ivoire

  • Teaching Hospital Center of Angre, Mother and Child Department, Felix Houphouet Boigny University, Abidjan, Cote d’Ivoire

  • Teaching Hospital Center of Angre, Mother and Child Department, Felix Houphouet Boigny University, Abidjan, Cote d’Ivoire

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