Pregnant woman Nguyen Thi T. (35 years old, Thu Dau Mot ward, Ho Chi Minh City) was brought to the hospital at 3:30 PM on March 23, 2026 while 35 weeks pregnant, in a state of a large uterine fibroid protruding into the vagina. This is a dangerous condition, which can threaten the health of both the pregnant woman and the fetus.
According to the medical record, the pregnant woman had given birth naturally twice before, and the pregnancy was normal. However, before the third pregnancy, she was found to have a large uterine fibroid protruding into the vagina and had surgery to remove the fibroid through the vagina at another medical facility.
By the 14th week of pregnancy, Ms. T came to Hung Vuong Hospital for a prenatal check-up and was recorded to have recurrent uterine fibroids with a size of 7x8x5cm, originating from the cervix and protruding into the vagina.
Here, Dr. Tran Thi Minh Hien, Deputy Head of the Social Work Department, Hung Vuong Hospital, performed surgery to remove the fibroid and advised the patient to continue pregnancy maintenance.
However, by the 29th week of pregnancy, the tumor continued to recur rapidly, showing signs of infection and necrosis. The pregnant woman had to be hospitalized and underwent a third surgery. During the surgery, doctors recorded a large uterine fibroid, about 20x20cm, protruding out of the vulva, showing signs of infection and pusification. After surgery, the pregnant woman was treated with antibiotics, stabilized her premature birth threat and discharged after 10 days for continued monitoring.
By the 35th week of pregnancy, during a routine follow-up examination, the fibroid tumor continued to recur and covered almost the entire cervix. Ultrasound results recorded the fetus being naked, weighing about 2,200g, with normal amniotic fluid, while the pregnant woman had chronic hepatitis B. After that, the pregnant woman experienced thick uterine contractions, 3-4 contractions in 10 minutes, forcing doctors to order emergency cesarean section combined with fibroid removal.
The surgery took place at 7:10 pm on March 24, 2026. The baby girl weighing 2.270g was born safely. During the surgery, doctors recorded a fibroid tumor originating from the left edge of the uterine segment, spreading to the broad ligament with a size of 15x10x5cm and the fibroid node protruding out of the vagina with a size of up to 14x14x20cm. The entire fibroid node weighing 1.100g was successfully removed.
After surgery, the health of the mother and baby was stable. Ultrasound results showed no abnormalities. On April 10, the mother and child were discharged from the hospital.
According to BS.CKII Nguyen Thi Anh Phuong, Head of Obstetrics and Gynecology Department at Hung Vuong Hospital, uterine fibroids during pregnancy account for about 2.5% to 10% of cases and can cause many complications such as miscarriage, premature birth, abnormal fetal presentation, infection or postpartum hemorrhage. However, this case is particularly rare due to the large tumor size, complex location and rapid recurrence during pregnancy.
In particular, fibroids develop from the cervix and spread to the broad ligaments, making the risk of urethral damage during surgery very high. At the same time, large tumors protruding into the vagina also increase the risk of bleeding, even having to have the uterus removed.
The successful surgery, both ensuring safety for the mother and baby, and preserving the uterus, requires high experience and skills from the surgical team. This is considered a rare and complex case in obstetrics.
