Publication:

Multidisciplinary planning with prophylactic REBOA in cesarean delivery for a giant uterine leiomyoma: a case report

Large uterine leiomyomas during pregnancy may significantly influence the mode of delivery, hinder access to the uterine cavity and increase the risk of hemorrhage during cesarean delivery. Evidence regarding prophylactic aortic balloon occlusion (REBOA) in this context is limited. A 25-year-old primigravid woman with gestational diabetes, preeclampsia and early-onset fetal growth restriction was found to have a previously undiagnosed giant uterine leiomyoma measuring 17×14×13 cm on magnetic resonance imaging. Due to its size and location, a cesarean delivery was planned at 34+2 weeks with prophylactic REBOA placement. Blood loss was within the expected range and balloon inflation was not required. Maternal and neonatal outcomes were favourable. Prophylactic REBOA may be considered in selected high-risk cesarean deliveries.