{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:03:10Z","timestamp":1756339390164,"version":"3.44.0"},"reference-count":27,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,12,16]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>Leuprolide acetate is commonly used to reduce the size of myomas before surgery. Initially, it stimulates pituitary gonadotropin secretion, followed by sustained suppression of gonadal function. However, the impact on pregnancy outcomes from inadvertent exposure remains unclear. This case involves a woman in her 30s, multiparous, with a 20-week-sized leiomyoma, who received two doses of 3.75\u2009mg subcutaneous leuprolide acetate, 15 days after menstruation, 4\u2009weeks apart. An ultrasound, conducted 2\u2009weeks after the last dose, accidentally revealed a viable intrauterine pregnancy at 8+6 weeks gestation. Her pregnancy progressed without complications, culminating in a term caesarean delivery without fetal anomalies. She opted for a total hysterectomy with bilateral salpingectomy 6\u2009months later. Despite unclear teratogenic effects, evidence suggests that leuprolide acetate does not significantly impact pregnancy outcomes.<\/jats:p>","DOI":"10.1136\/bcr-2024-262211","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T01:30:23Z","timestamp":1735867823000},"page":"e262211","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Unintentional exposure to leuprolide acetate during early pregnancy with a huge intramural myoma"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2175-4926","authenticated-orcid":false,"given":"Prachawanee","family":"Nuchpramool","sequence":"first","affiliation":[{"name":"Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7784-8471","authenticated-orcid":false,"given":"Chatsaran","family":"Thanapongpibul","sequence":"additional","affiliation":[{"name":"Ramathibodi Medical School, Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6361-7528","authenticated-orcid":false,"given":"Ratchapol","family":"Siriprapaphan","sequence":"additional","affiliation":[{"name":"Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9123-7649","authenticated-orcid":false,"given":"Narathorn","family":"Kulthamrongsri","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Hawai\u2019i at M\u0101noa John A Burns School of Medicine, Honolulu, Hawaii, USA"},{"name":"Cardiovascular Department, Mayo Clinic Arizona, Scottsdale, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,2]]},"reference":[{"key":"2025082701254532000_18.1.e262211.1","article-title":"Large Uterine Fibroids in Pregnancy with Successful Caesarean Myomectomy","volume":"2020","author":"Eyong","year":"2020","journal-title":"Case Rep Obstet Gynecol"},{"key":"2025082701254532000_18.1.e262211.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(15)30338-8"},{"key":"2025082701254532000_18.1.e262211.3","article-title":"Uterine Leiomyomas and Infertility: A Comparison of National and International Guidelines","volume":"15","author":"Michos","year":"2023","journal-title":"Cureus"},{"key":"2025082701254532000_18.1.e262211.4","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1097\/AOG.0000000000004745","article-title":"Depot Medroxyprogesterone Acetate Use and the Development and Progression of Uterine Leiomyoma","volume":"139","author":"Harmon","year":"2022","journal-title":"Obstet Gynecol"},{"key":"2025082701254532000_18.1.e262211.5","doi-asserted-by":"crossref","first-page":"e100","DOI":"10.1097\/AOG.0000000000004401","article-title":"Management of Symptomatic Uterine Leiomyomas: ACOG Practice Bulletin, Number 228","volume":"137","year":"2021","journal-title":"Obstet Gynecol"},{"key":"2025082701254532000_18.1.e262211.6","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1111\/j.1479-828X.2006.00602.x","article-title":"Perinatal outcome of pregnancies after inadvertent exposure to gonadotrophin-releasing hormone analogue","volume":"46","author":"Tan","year":"2006","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"2025082701254532000_18.1.e262211.7","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1016\/j.fertnstert.2009.05.067","article-title":"Follicular development, acquisition of mature oocytes, and pregnancy after 2 weeks of leuprolide acetate administration during the midluteal phase","volume":"92","author":"Vlahos","year":"2009","journal-title":"Fertil Steril"},{"key":"2025082701254532000_18.1.e262211.8","unstructured":"Swayzer DV , Gerriets V . Leuprolide. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2024."},{"key":"2025082701254532000_18.1.e262211.9","doi-asserted-by":"crossref","unstructured":"Hodgson R , Bhave Chittawar P , Farquhar C . GnRH agonists for uterine fibroids. Cochrane Database Syst Rev 2017;PMCID. doi:10.1002\/14651858.CD012846","DOI":"10.1002\/14651858.CD012846"},{"key":"2025082701254532000_18.1.e262211.10","first-page":"83","article-title":"Clinical applications of gonadotropin-releasing hormone analogues: a broad impact on reproductive medicine","volume":"4","author":"Saleh","year":"2023","journal-title":"F S Rep"},{"key":"2025082701254532000_18.1.e262211.11","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/S0015-0282(16)55138-3","article-title":"Efficacy of a low-dose leuprolide acetate depot in the treatment of uterine leiomyomata in Japanese women","volume":"58","author":"Watanabe","year":"1992","journal-title":"Fertil Steril"},{"key":"2025082701254532000_18.1.e262211.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)60486-7"},{"key":"2025082701254532000_18.1.e262211.13","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/0028-2243(92)90228-Q","article-title":"The response of uterine fibroids to GnRH-agonist treatment can be predicted in most cases after one month","volume":"45","author":"Hackenberg","year":"1992","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2025082701254532000_18.1.e262211.14","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1093\/humrep\/11.suppl_3.3","article-title":"GnRH agonists and uterine leiomyomas","volume":"11 Suppl 3","author":"Broekmans","year":"1996","journal-title":"Hum Reprod"},{"key":"2025082701254532000_18.1.e262211.15","doi-asserted-by":"publisher","DOI":"10.1007\/BF01228095"},{"key":"2025082701254532000_18.1.e262211.16","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-54-5-1078"},{"key":"2025082701254532000_18.1.e262211.17","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1159\/000292765","article-title":"Effect of LHRH and its analogues on the progesterone secretion of human granulosa cells in vitro","volume":"34","author":"T\u00f6r\u00f6k","year":"1992","journal-title":"Gynecol Obstet Invest"},{"key":"2025082701254532000_18.1.e262211.18","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1016\/S0015-0282(16)56396-1","article-title":"Gonadotropin-releasing hormone agonist administration in early human pregnancy is associated with normal outcomes","volume":"60","author":"Wilshire","year":"1993","journal-title":"Fertil Steril"},{"key":"2025082701254532000_18.1.e262211.19","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/14.5.1368"},{"key":"2025082701254532000_18.1.e262211.20","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/12.10.2118"},{"key":"2025082701254532000_18.1.e262211.21","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(00)01524-7"},{"key":"2025082701254532000_18.1.e262211.22","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1016\/0002-9378(87)90092-5","article-title":"Infusion of gonadotropin-releasing hormone agonist during pregnancy: maternal and fetal responses in primates","volume":"156","author":"Sopelak","year":"1987","journal-title":"Am J Obstet Gynecol"},{"key":"2025082701254532000_18.1.e262211.23","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/S0015-0282(16)53361-5","article-title":"Midluteal gonadotropin-releasing hormone analog administration in early pregnancy","volume":"53","author":"Ron-El","year":"1990","journal-title":"Fertil Steril"},{"key":"2025082701254532000_18.1.e262211.24","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/"},{"key":"2025082701254532000_18.1.e262211.25","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/"},{"key":"2025082701254532000_18.1.e262211.26","first-page":"587","article-title":"GnRH agonist exposure during the first trimester of pregnancy","volume":"81","author":"Young","year":"1993","journal-title":"Obstet Gynecol"},{"key":"2025082701254532000_18.1.e262211.27","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/S0065-3101(24)00308-6","article-title":"Human teratogenicity","volume":"33","author":"Shepard","year":"1986","journal-title":"Adv Pediatr"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-262211","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:25:57Z","timestamp":1756283157000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-262211"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,2]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/bcr-2024-262211"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-262211","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}