Known Intramural Uterine Fibroid in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#18136

SMLE Question #18136

Obstetrics & Gynecology General Gynecology

Objective: OBJ-OBG-214

Last updated: February 2026
A 37-year-old primigravida at 34 weeks’ gestation with a known intramural uterine fibroid has 24 hours of localized lower abdominal pain. Examination shows focal tenderness over a palpable firm uterine mass; there are no contractions and the cervix is closed. Fetal heart rate tracing is reassuring. Obstetric ultrasound shows a single live fetus with normal amniotic fluid and a 9-cm intramural fibroid with heterogeneous echotexture; placenta is not low-lying. What is the most appropriate management?

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