Ensuring a Mother’s Health For a Healthy Pregnancy

Background

A pregnant woman with multiple large uterine fibroids, presented at the CK Birla Hospital, Gurgaon. These fibroids, measuring 6×6 cm, 6×7 cm, and 7×8 cm, posed a considerable challenge to her pregnancy. Typically, such cases are complicated and carry a high risk to both the mother and the unborn child.

Investigation & Analysis

The patient’s journey began with concerning symptoms of delayed periods and vaginal spotting on & off. Her initial presentation revealed a woman who was severely anaemic, pale, and thin, with a BMI of only 20. Detailed investigations, including ultrasound, were conducted, which unveiled a 6-week pregnancy with multiple uterine fibroids of significant sizes. Anaemia further complicated her antenatal condition, as she struggled with abdominal cramps due to these growing fibroids. Despite limited space for the foetus to grow, her body managed to gain 2.4 kg of weight, battling for adequate blood supply. The pregnancy progressed to 39 weeks, and she delivered vaginally through natural birth, which proved to be a lifesaving decision, sparing her from blood loss and ensuring a faster recovery compared to a caesarean section.

Treatment and Management

Dr Aruna Kalra, Director of Obstetrics & Gynaecology at CK Birla Hospital, Gurgaon, played a pivotal role in the patient’s journey. To mitigate the risks associated with fibroid-complicated pregnancies, the medical team initiated a comprehensive management plan. Anaemia was addressed through iron therapy, and preterm labour was prevented with uterine relaxant and anti-inflammatory medications. Despite the challenges posed by the fibroids, the patient’s determination, coupled with careful medical intervention, allowed for a successful vaginal delivery.

Post-Operative Care

3 months post this delivery, the patient underwent a laparoscopic myomectomy to remove the uterine fibroids. Remarkably, uterine reconstruction was performed perfectly without the need to open the uterine cavity. This surgical procedure ensured that the patient could consider a second pregnancy naturally, and she did so after six months.

During her second pregnancy, rigorous monitoring and follow-up were implemented due to the scar from the myomectomy. As expected, the second baby displayed healthier growth in terms of weight. Continuous surveillance and care were provided for the myomectomy scar. Ultimately, the patient.