Download PDF
CC BY-NC-ND 4.0 · AJP Rep 2024; 14(01): e85-e87
DOI: 10.1055/a-2202-4234
Case Report

A Case of an Obstructed Delivery by a Large, Lower Uterine Segment Fibroid Interlocked with a Fetal Mentum

Sarah E. Miller 
1   Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California
,
Hayley E. Miller
1   Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California
,
Anne R. Waldrop
1   Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California
,
Scarlett D. Karakash
1   Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California
,
Kate A. Shaw
1   Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Uterine leiomyomata are associated with many pregnancy complications and will likely become increasingly common as the average age of childbearing increases. We describe a case of an obstructed delivery by a large fibroid. A 37-year-old G2P1001 with a 10-cm anterior, lower uterine segment fibroid presented for labor induction. Labor was complicated by arrest of descent due to suspected obstruction of the fetal body by the fibroid after descent of the fetal head, and delivery during cesarean section was complicated by apparent interlocking of the fetal mentum with the fibroid. Large, anterior lower uterine segment fibroids have the potential to obstruct delivery of the fetal head or of the fetal body, and these patients should be counseled regarding the potential for complications via both vaginal and cesarean deliveries.

Keywords

cesarean section - leiomyomas of the uterus - obstructed delivery - labor - management


Publication History

Received: 18 October 2021

Accepted: 22 October 2023

Accepted Manuscript online:
01 November 2023

Article published online:
21 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Laughlin SK, Baird DD, Savitz DA, Herring AHS, Hartmann KE. Prevalence of uterine leiomyomas in the first trimester of pregnancy: an ultrasound-screening study. Obstet Gynecol 2009; 113 (03) 630-635
    CrossrefPubMedGoogle Scholar
  • 2 Qidwai GI, Caughey AB, Jacoby AF. Obstetric outcomes in women with sonographically identified uterine leiomyomata. Obstet Gynecol 2006; 107 (2 Pt 1): 376-382
    CrossrefPubMedGoogle Scholar
  • 3 Mathews TJ, Hamilton BE. Mean age of mothers is on the rise: United States, 2000–2014. NCHS Data Brief 2016; (232) 1-8
    PubMedGoogle Scholar
  • 4 Stewart EA, Cookson CL, Gandolfo RA, Schulze-Rath R. Epidemiology of uterine fibroids: a systematic review. BJOG 2017; 124 (10) 1501-1512
    CrossrefPubMedGoogle Scholar
  • 5 Rice JP, Kay HH, Mahony BS. The clinical significance of uterine leiomyomas in pregnancy. Am J Obstet Gynecol 1989; 160 (5 Pt 1): 1212-1216
    CrossrefPubMedGoogle Scholar
  • 6 Vergani P, Locatelli A, Ghidini A, Andreani M, Sala F, Pezzullo JC. Large uterine leiomyomata and risk of cesarean delivery. Obstet Gynecol 2007; 109 (2 Pt 1): 410-414
    CrossrefPubMedGoogle Scholar