Primary postpartum haemorrhage due to a large submucosal nonpedunculated uterine leiomyoma: a case report and review of the literature

The complications of leiomyomas during pregnancy are very rare and can be divided into those occurring during pregnancy, at delivery and in puerperium. We present an unusual complication of large submucosal nonpedunculated uterine leiomyoma in puerperium. The patient was a 32-year-old woman, gravida...

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Bibliographic Details
Published in:Clinical and experimental obstetrics & gynecology 2003, Vol.30 (2-3), p.156-158
Main Authors: Akrivis, Ch, Varras, M, Bellou, A, Kitsiou, E, Stefanaki, S, Antoniou, N
Format: Article
Language:English
Subjects:
Adult
Female
Hemoglobins - analysis
Humans
Hysterectomy
Leiomyoma - complications
Leiomyoma - pathology
Leiomyoma - surgery
Postpartum Hemorrhage - etiology
Pregnancy
Pregnancy Complications, Neoplastic
Uterine Neoplasms - complications
Uterine Neoplasms - pathology
Uterine Neoplasms - surgery
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Summary:The complications of leiomyomas during pregnancy are very rare and can be divided into those occurring during pregnancy, at delivery and in puerperium. We present an unusual complication of large submucosal nonpedunculated uterine leiomyoma in puerperium. The patient was a 32-year-old woman, gravida 2, para 1, who was admitted to our department from a private maternity clinic with a considerable drop in haemoglobin 23 hours after delivery of a healthy boy. The placenta had easily and spontaneously delivered. On admission to our department her haemoglobin was 6.3 g/dl. Pelvic examination disclosed the presence of fresh blood clots in the vaginal vault. A circular firm structure, 12 by 12 cm, was noted within the external cervical os. This mass was immovable. Total abdominal hysterectomy without salpingo-oophorectomy was immediately performed and the patient's postoperative course was uneventful. In conclusion, in this patient the uterine leiomyoma obstructed the cervical os and prevented the passage of lochia resulting in haematometra, uterine atony and subsequent serious uterine haemorrhage. In such cases ostetricians and gynaecologists should proceed immediately with surgical intervention to avoid a life-threatening situation.
ISSN:0390-6663