Hemoperitoneum caused by a bleeding myoma in pregnancy.

Abstract:

:The prevalence of uterine myomas during pregnancy is estimated to range from 0.3% to 2.6%. Although leiomyomas usually remain asymptomatic, in one often cases they may be complicated. The management of uterine fibroids during pregnancy is largely conservative and surgical removal is generally delayed until post partum. A 37-year-old pregnant woman (15 weeks) with a history of gynecologic examination several hours before presented with lower abdominal pain and signs of acute abdomen. She was para-2, as she had delivered a healthy child 12 years before, and current pregnancy was uncomplicated until presentation. Intra-abdominal hemorrhage was suspected and she underwent immediate exploratory laparotomy, which revealed massive hemoperitoneum. A subserous uterine leiomyoma of 8.5x6.5 cm was found in the fundus area, with an actively bleeding ruptured vessel on its dome. Myomectomy was successfully performed and 1.5 liter of blood and blood clots were evacuated from the peritoneal cavity. The histology report showed sections of interlacing bundles of smooth muscles with areas of bleeding and necrotic degeneration. The postoperative course and subsequent antenatal period were uneventful. The woman went into spontaneous labor at 38 weeks and delivered vaginally a healthy male baby. This rare case ofintra-abdominal hemorrhage due to bleeding myoma supports other recent studies, which have demonstrated that myomectomy may be successfully performed during pregnancy in selected circumstances.

journal_name

Acta Clin Croat

journal_title

Acta clinica Croatica

authors

Kasum M

subject

Has Abstract

pub_date

2010-06-01 00:00:00

pages

197-200

issue

2

eissn

0353-9466

issn

1333-9451

journal_volume

49

pub_type

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