Severe intrauterine growth restriction associated with the development of a submucosal leiomyoma during pregnancy - A case report

Small, intramural leiomyomas are not generally considered a risk factor for poor reproductive outcomes. CASE: A patient with a 6mm intraniural leiomyoma and a normal uterine cavity by hysteroscopic evaluation who conceived after in vitro fertilization developed severe early-onset intrauterine growth restriction (IUGR), leading to pregnancy terminal at 23.4 weeks' gestation. At 6 weeks postpartum, a 1.7-cm, intracavitary leiomyoma was detected on ultrasound evaluation and removed by hysteroscopic resection. The patient conceived in a subsequent in vitro fertilization cycle and gave birth to monozygotic twins with appropriate weights at 34 weeks of gestation. In the absence of other identifiable etiologies of the 1UGR, it is plausible that the small, intramural leiomyoma enlarged and migrated into the cavity, causiug abnormal placentation and leading to fetal growth restriction in the first pregnancy. CONCLUSION: Uterine cavity reevaluation is recommended in the investigation of IUGR before a womans attempts further pregnancies.