Myomatous erythrocytosis syndrome (MES) is a condition where uterine myoma is associated with erythrocytosis. It is a rare condition which is even rarer in pregnancy. This is no report of MES in pregnancy in India. Our case is 31 years old G3P1L1A1 with previous 2 myomectomies who presented at 32 weeks with cellulitis of right lower limb and severe pre-eclampsia. She was already diagnosed to have uterine myomas in the 1st trimester sonogram. On routine investigations she was found to have erythrocytosis. Her erythropoietin levels were also elevated, and repeated sonograms showed progressive increase in the size of myoma. She was managed preoperatively with venesection and hydration. Later she was taken up for classical Cesarean section and myomectomy with tubal sterilization at 36 weeks. Postoperatively her haemoglobin and haematocrit dropped. Her erythropoietin levels also showed a marked downward trend. Histopathology of myomectomy specimen reported as leiomyoma. Erythropoietin and its receptor could not be demonstrated in the surgical specimen for the want of investigation felicities.
