CONSERVATIVE MANAGEMENT OF PLACENTA INVADING INTO LEIOMYOMA

摘要

Leiomyoma uteri with pregnancy may lead to spontaneous abortion, preterm delivery, obstructed labor, or malpresentation. We report an unusual case of leiomyoma with pregnancy, resulting in preterm delivery, followed by retained placenta which was invading into the leiomyoma. Placenta was left inside and treated successfully with methotrexate.A 25-year-old primigravida with 25-week pregnancy presented with complaints of pain abdomen off and on for 1 month and leaking per vaginum. Obstetrical examination revealed a 32-week size uterus. The fetal parts were felt in the upper part of uterus, and a hard mass (13 x 10 cm) was found arising from the outer surface of lower uterine segment. The cervix was 5 to 6 cm dilated; the membranes were absent; and fibroid was felt arising from lower uterine segment, which was projecting into the uterine cavity. The presenting part was high up and