Successful myomectomy of a bleeding myoma in a twin pregnancy

Uterine fibroids are often seen in pregnancy, with a reported prevalence between 0.1% and 15%. The incidence is increasing because more women delay pregnancy. The effect of uterine fibroids on fertility and pregnancy depends on number, size and location. In 2% of all pregnancies with uterine fibroids, conservative therapy fails and myomectomy by laparotomy or laparoscopy had to be performed, mainly for unbearable pain or haemoperitoneum. In these cases myomectomy appears to improve pregnancy outcome, although uterine rupture may occur at a time later in pregnancy.