Presentation
Pregnant patient G1P0A0C0, asymptomatic. First obstetric ultrasound.
Patient Data
Ultrasound shows diffuse symmetrical uterine enlargement. The myometrium is heterogeneous, with innumerable poorly defined confluent hypoechoic nodules, replacing most of the uterine parenchyma. Color Doppler demonstrates hypervascularity of the myometrium.
The fetus and placenta are morphologically normal. Gestational age of 14.5 weeks by ultrasound.
The myometrium produces a mild external compression on the fetus and placenta.
Case Discussion
The patient has a history of undergoing myomectomy. The hypoechoic nodules in the myometrium on today's scan are compatible with leiomyomatous nodules. The findings correspond to a diffuse uterine leiomyomatosis1-3 in a pregnant patient.