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Hemoperitoneum caused by a bleeding myoma in pregnancy.
Acta Clin Croat. 2010 Jun; 49(2):197-200.AC

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.

Authors+Show Affiliations

Human Reproduction Unit, University Department of Obstetrics and Gynecology, Zagreb University Hospital Center, Zagreb, Croatia. mkasum@gmail.com

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

21086740

Citation

Kasum, Miro. "Hemoperitoneum Caused By a Bleeding Myoma in Pregnancy." Acta Clinica Croatica, vol. 49, no. 2, 2010, pp. 197-200.
Kasum M. Hemoperitoneum caused by a bleeding myoma in pregnancy. Acta Clin Croat. 2010;49(2):197-200.
Kasum, M. (2010). Hemoperitoneum caused by a bleeding myoma in pregnancy. Acta Clinica Croatica, 49(2), 197-200.
Kasum M. Hemoperitoneum Caused By a Bleeding Myoma in Pregnancy. Acta Clin Croat. 2010;49(2):197-200. PubMed PMID: 21086740.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hemoperitoneum caused by a bleeding myoma in pregnancy. A1 - Kasum,Miro, PY - 2010/11/20/entrez PY - 2010/11/23/pubmed PY - 2010/12/25/medline SP - 197 EP - 200 JF - Acta clinica Croatica JO - Acta Clin Croat VL - 49 IS - 2 N2 - 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. SN - 0353-9466 UR - https://www.unboundmedicine.com/medline/citation/21086740/Hemoperitoneum_caused_by_a_bleeding_myoma_in_pregnancy_ L2 - http://www.diseaseinfosearch.org/result/5922 DB - PRIME DP - Unbound Medicine ER -