Uterine Fibroid Affecting Pregnancy

Presentation:
C.D., a 34 year old G1P0 presents to the clinic for routine prenatal visit at 17 weeks with complaints of pelvic pain. First trimester ultrasound confirmed presence of an intramural fibroid/leiomyoma. Her VS were within normal limits and her weight gain was appropriate in comparison to her pre-pregnancy weight and her gestational age. Fetal movement was positive, fetal heart rate 140. Fundal height was high for gestational age at 19cm. Irregular contour of uterus was observed. Pt was negative for bleeding and contractions. Cervix was closed.

Differential Diagnosis:
Uterine fibroids affecting pregnancy, Pre-term labor

Diagnosis:
Based on findings from the woman's history and physical exam it was determined that her discomfort was due to uterine fibroids/intramural leiomyoma.

Treatment:
Discussed with patient taking OTC Tylenol® for discomfort and wearing pregnancy girdle for support. Discussed calling if symptoms were not relieved with Tylenol® and pregnancy girdle or if symptoms worsened. Also discussed calling if she had any vaginal bleeding, shortness of breath, temperature >101.3. Return to care in 2 weeks.

Outcome:
Follow up with patient 2 days later: Pt's symptoms relieved with Tylenol® and wearing pregnancy girdle during the day.