A case of diffuse uterine leiomyomatosis who had two successful pregnancies after medical management.

OBJECTIVE

To describe a case report of diffuse uterine leiomyomatosis who had successful pregnancy twice following conservative management.

DESIGN

Retrospective report.

SETTING

Private general hospital.

PATIENT(S): A nulliparous woman 25 years of age presented with menorrhagia and infertility. She had innumerable small fibroids of 4-42 mm size throughout the myometrium. Size of the symmetrically enlarged uterus was 131×80×60 mm, clinically corresponding to that of 12 weeks of gestation.

INTERVENTION(S): She received a GnRH analogue (GnRHa; leuprolide acetate) 3.75 mg per month for 6 months.

MAIN OUTCOME MEASURE(S): Reduction of uterus size, menstrual amount, conception, pregnancy outcome.

RESULT(S): Enlarged uterus reduced to almost normal size after 3 doses of GnRHa. She did not experience heavy bleeding during menstruation. She conceived spontaneously in the first cycle after discontinuation of GnRHa. Antenatal course was uneventful. A healthy male baby of 2.5 kg was delivered by cesarean section at 39 weeks. The placenta weighed 330 g. There was no postpartum hemorrhage. She conceived spontaneously for the second time in the first cycle after resumption of menses. Antenatal, intranatal (cesarean section), and postnatal courses of the second pregnancy were uneventful. The second neonate weighed 3.0 kg and the placenta 400 g.

CONCLUSION(S): Conservative treatment may help to achieve successful pregnancy in case of diffuse uterine leiomyomatosis.