At this time, the growth of uterine myomas during pregnancy cannot be predicted. Major complications of pregnancy appear to be related to whether the placenta and the myoma are in contact. The location and number of myomas, especially in the lower uterine segment, increases the likelihood of cesarean birth and malpresentation. Frequent ultrasound evaluations to monitor fetal growth and presentation and the size of the myoma should be considered in pregnant women with uterine myomas. Surgical resection of myomas should be reserved for those pregnant women with symptomatic pedunculated myomas with a small stalk. In those women with a pregnancy complication owing to the myoma, resection should be considered prior to the next pregnancy.