Spontaneous Reduction of an Incarcerated Gravid Uterus With a Giant Uterine Fibroid in Late Pregnancy: A Case Report.

Incarceration of the gravid uterus is a rare obstetric complication causing serious maternal and fetal morbidity. This report describes the case of a 43-year-old gravida 3, para 0 woman with a giant uterine fibroid who was diagnosed with an incarcerated gravid uterus at 24 gestational weeks based on transvaginal ultrasonography and magnetic resonance imaging (MRI). The largest fibroid measured 15 cm in maximum diameter and was thought to limit uterine mobility; therefore, conservative management with a planned cesarean delivery was selected. Repeat MRI at 34 weeks unexpectedly demonstrated spontaneous reduction of the incarcerated uterus, with the cervix restored to its normal caudal position. Hence, delivery planning and surgical strategy were revised based on updated anatomical findings. Emergency cesarean delivery was successfully performed at 36 weeks, without recurrence of uterine incarceration. Continuous anatomical reassessment throughout pregnancy, including the third trimester, is essential for optimizing peripartum management and avoiding preventable complications.