Three-Dimensional-Printed Uterine Model for Surgical Planning of a Cesarean Delivery Complicated by Multiple Myomas.

Background: Uterine myomas encountered at cesarean delivery increase the complexity and risk of the procedure. Preoperative planning of such deliveries may help optimize patient outcomes. The application of three-dimensional printing technology is rapidly expanding in many surgical specialties. We created a three-dimensional-printed model from the magnetic resonance images (MRIs) of a gravid uterus with multiple myomas for surgical planning of cesarean delivery.

Instrument: A three-dimensional-printed uterine model from MRIs of a pregnant patient with multiple uterine myomas as a tool for planning cesarean delivery.

Experience: A 33-year-old woman with a myomectomy history presented to our institution for prenatal care. Initial ultrasound imaging revealed multiple uterine myomas. A three-dimensional-printed uterine model, based on subsequent MRI, was created for presentation at an obstetric multidisciplinary meeting. The model accurately represented the number, size, and locations of uterine myomas, aiding surgical planning, including skin and uterine incisions. At the time of cesarean delivery, the model was directly correlated with patient anatomy to further determine the optimal placement of uterine incision. Maternal and fetal outcomes were excellent.

Conclusion: Three-dimensional-printed models, through improved surgical planning, could optimize outcomes for patients with uterine myomas undergoing cesarean delivery.