{
  "abstract": "Although leiomyomata are common, it is rare for them to be associated with severe complications in pregnancy. We describe the case of a primigravida with a known multifibroid uterus. She presented at 16 weeks’ gestation with abdominal pain, distension, raised serum inflammatory markers and features of a gastrointestinal ileus. The patient was initially managed conservatively; however, her clinical condition deteriorated and she developed a severe systemic inflammatory response syndrome (SIRS). Imaging demonstrated red degeneration of two large leiomyomata, small bowel obstruction and ascites. Following a multidisciplinary team meeting, the patient was offered an antenatal abdominal myomectomy, or a termination of pregnancy plus deferred elective myomectomy. She underwent a successful abdominal myomectomy at 17+4 weeks’ gestation and subsequently had an uncomplicated elective Caesarean section at 39 weeks’ gestation. This report highlights the importance of multidisciplinary team management and informed consent in a surgically complex patient in the second trimester of pregnancy.",
  "authors": [
    {
      "affiliations": [
        "Department of Gynaecology, St George’s Healthcare NHS Trust, London, UK"
      ],
      "name": "Robyn Edney"
    },
    {
      "affiliations": [
        "Department of Gynaecology, St George’s Healthcare NHS Trust, London, UK"
      ],
      "name": "Caroline Yap"
    },
    {
      "affiliations": [
        "Department of Anaesthetics, St George’s Healthcare NHS Trust, London, UK"
      ],
      "name": "Sophie Childs"
    },
    {
      "affiliations": [
        "Department of Gynaecology, St George’s Healthcare NHS Trust, London, UK"
      ],
      "name": "Sourav Das"
    },
    {
      "affiliations": [
        "Department of Gynaecology, St George’s Healthcare NHS Trust, London, UK"
      ],
      "name": "Paula Fagan"
    }
  ],
  "title": "Second trimester semi-elective abdominal myomectomy to manage severe systemic inflammatory response syndrome secondary to fibroid degeneration",
  "uid": "04cd554b-3bfb-52c6-baad-d1f41a4a6e50"
}