Hysterotomy and Myomectomy for Retained Placenta in a Uterus: A Case Report

Retained placenta is a common complication, especially in mid-trimester miscarriage. However, when it is further complicated by the presence of multiple fibroids negating removal through the vagina route, it becomes a problematic finding necessitating laparotomy for both myomectomy and removal of the placenta. A 36-year-old G3P0+2 who had a miscarriage at 19 weeks 5 days gestation had a retained placenta with failed attempts at both medical and manual removal due to multiple uterine fibroids. She eventually had a hysterotomy and myomectomy with satisfactory results. The intraoperative challenges were removal of very many uterine fibroid seedlings of various sizes including large ones in a gravid uterus leading to an estimated blood loss of 4,500 ml and necessitating the transfusion of a total of eight units of blood. This case highlights one of the several complications of fibroids coexisting with pregnancy and its management.