Transverse position of a fetus caused by a giant leiomyoma in the lower segment of the uterus: A case report

Nel J.T. ; Schaetzing A.E. (1985)

The original publication is available at http://www.samj.org.za

A 20-year-old primigravida presented at 39 weeks' gestation with the fetus lying in the transverse position. Ultrasound examination indicated an anterior placenta praevia grade II-III. During a vertical lower uterine segment caesarean section, a giant intramural leiomyoma of approximately 25 x 25 cm was found. The uterine incision was extended into the upper segment and a healthy male fetus of 2,568 g delivered. The placenta was situated anteriorly but did not extend into the lower uterine segment. A myomectomy had to be performed to enable closure of the uterine incision. The association of a transverse lie with anterior implantation of the placenta may result in a false ultrasound diagnosis because the lower anterior portion of the uterine wall and the attached portion of the placenta simulate a placenta praevia. In our case, an unsuspected leiomyoma in the lower segment contributed to this. Furthermore, this case illustrates the advantage of using a lower uterine segment vertical incision when performing a caesarean section for transverse lie. The incision can then readily be extended into the upper uterine segment when necessary.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/7514
This item appears in the following collections: