Innovative Journal Journal of Medical Research and Health Sciences 2589-9031 4 7 2021 7 8 Multiple Myomectomy in Pregnancy and at Caesarean Section: a case report of a patient managed at the Hospital des Oliviers in Lubumbashi. Democratic Republic of Congo 1 Kapya mukeya Gabriel Department of Gynecology and Obstetrics, Faculty of Medicine, University of Lubumbashi, Democratic Republic of Congo Chola Mwansa Joseph Department of Gynecology and Obstetrics, Faculty of Medicine, University of Lubumbashi, Democratic Republic of Congo Ilunga Louis Hospital des Oliviers, Lubumbashi, Democratic Republic of Congo Kalenga Muenze Kayamba Prosper Department of Gynecology and Obstetrics, Faculty of Medicine, University of Lubumbashi, Democratic Republic of Congo Kakoma Sakatolo Zambeze Jean-Baptiste Department of Gynecology and Obstetrics, Faculty of Medicine, University of Lubumbashi, Democratic Republic of Congo Journal Article https://doi.org/10.15520/jmrhs.v4i7.366 Abstract Myomectomy during pregnancy is rarely performed because of the risks of premature interruption of the pregnancy, infection and uncontrollable uterine haemorrhage. We report here a case of myomectomy performed at 19 weeks of gestation in a 27-year old primigravida. Surgical intervention was necessary due to intense and refractory abdominal pain as a result of a rapid increase in size of a subserosal myoma. Under adequate analgesia and tocolytic therapy, the operation resulted in the ablation of three subserosal myomas. A sessile subserosal myoma was left untouched. Post-operative recovery was uneventful and the pregnancy progressed without any complications. At 38 weeks, the patient delivered a male baby weighing 3050 grams via elective caesarean section due to breech presentation. APGAR score was 9 and 10 at 1 and 5 minutes respectively. At caesarean section, we also proceeded without any trouble, to the resection not only of the intramural and subserosal myoma previously left untouched but also of nine other subserosal myomas discovered intra-operatively. When performed under certain circumstances, myomectomy during pregnancy may lead to a favourable obstetric outcome, especially by controlling pain and the prevention of complications of the myomas on the pregnancy and vice-versa. On the other hand, myomectomy during caesarean section can be performed without complications especially in the presence of subserosal myomas of less than 5 cm in diameter. Milazzo, Giusi Natalia, Catalano, Angelica, Badia, Valentina, Mallozzi, Maddalena, Caserta, Donatella, Myoma and myomectomy: Poor evidence concern in pregnancy, Journal of Obstetrics and Gynaecology Research, 2017, 43, 1789, 1804, 1341-8076, Wiley, 10.1111/jog.13437, https://dx.doi.org/10.1111/jog.13437 Allameh, Tajossadat, Allameh, Zahra, Successful Myomectomy in the Second Trimester of Pregnancy, Advanced Biomedical Research, 2019, 8, 1, 60, 60, 2277-9175, 10.4103/abr.abr_236_18, Medknow, https://dx.doi.org/10.4103/abr.abr_236_18 Zhao, Rong, Wang, Xin, Zou, Liying, Zhang, And Weiyuan, Outcomes of myomectomy at the time of cesarean section among pregnant women with uterine fibroids: a retrospective cohort study,hindawi biomed research international volume 2019; 2019:7576934, 6 pages , Collins S, Arulkumaran S, Hayes K, Jackson S And Impey L. Oxford handbook of obstetrics and gynaecology, third edition, oxford univer sity press, uk 2013 Jhalta, Pawan, Negi, Sonam Gialchhen, Sharma, Vikas, Successful myomectomy in early pregnancy for a large asymptomatic uterine myoma: case report, Pan African Medical Journal, 2016, 24, 228, 228, 1937-8688, 10.11604/pamj.2016.24.228.9890, Pan African Medical Journal, https://dx.doi.org/10.11604/pamj.2016.24.228.9890 Machado, Lovina S M, Gowri, Vaidyanathan, Al-Riyami, Nihal, Al-Kharusi, Lamya, Caesarean Myomectomy : Feasibility and Safety , Sultan Qaboos University Medical Journal, 2012, 12, 190, 196, 2075-0528, Sultan Qaboos University Medical Journal, 10.12816/0003112, https://dx.doi.org/10.12816/0003112 Levast, F, Legendre, G, Pe, Bouet, Sentilhes, L, Management of uterine myomas during pregnancy, gynecol obstet fertil, 2016, 44, 6, 350, 354 Cho, Hyunjin, Rupture of a myomectomy site in the third trimester of pregnancy after myomectomy, septoplasty and cesarean section: A case report, Case Reports in Women's Health, 2018, 19, e00066, e00066, 2214-9112, 10.1016/j.crwh.2018.e00066, Elsevier BV, https://dx.doi.org/10.1016/j.crwh.2018.e00066 , Edmonds D.K. Dewhurst’s texbook of obstetrics& gynaea- cology eighth edition, wiley blackwell a wiley j &sons, ltd, publication, london, uk, 2012 Kumar R, Ramesh, The Utility of Caesarean Myomectomy as a Safe Procedure: A Retrospective Analysis of 21 Cases with Review of Literature, JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2014, 8, 9, 5, 08, 2249-782X, 10.7860/jcdr/2014/8630.4795, JCDR Research and Publications, https://dx.doi.org/10.7860/jcdr/2014/8630.4795 , Jones Iii H.W And Rock J.A. Te linde’s operative gynecology, eleventh edition, wolters kluwer, philadelphia 2015. , Awoleke J O. Myomectomy during caesarean birth in fibroid-endemic, low-resource settings, hindawipublishingcorporation obstetricsandgynecologyinternational. 2013;2013:520834: 6 pages , Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L., Bradshaw K.D., Cunningham F.G., Calver L.E. Williams gynecology.second edition, themc graw hill companies, new york, 2012