Document Detail


Hemoperitoneum caused by a bleeding myoma in pregnancy.
MedLine Citation:
PMID:  21086740     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
Miro Kasum
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Acta clinica Croatica     Volume:  49     ISSN:  0353-9466     ISO Abbreviation:  Acta Clin Croat     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-11-19     Completed Date:  2010-12-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9425483     Medline TA:  Acta Clin Croat     Country:  Croatia    
Other Details:
Languages:  eng     Pagination:  197-200     Citation Subset:  IM    
Affiliation:
Human Reproduction Unit, University Department of Obstetrics and Gynecology, Zagreb University Hospital Center, Zagreb, Croatia. mkasum@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Hemoperitoneum / etiology*
Humans
Infant, Newborn
Leiomyoma / blood supply,  complications*,  surgery
Male
Pregnancy
Pregnancy Complications, Neoplastic* / surgery
Uterine Neoplasms / blood supply,  complications*,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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