Rare complication of fibroids in pregnancy: Spontaneous fibroid rupture

Abstract

Uterine fibroids in pregnancy present with numerous complications. However, spontaneous rupture is a rare and potentially life-threatening event. We report a case of a 43-year-old multiparous woman who presented with hypovolemic shock secondary to a ruptured uterine fibroid 2 days after a spontaneous vaginal delivery. Emergency laparotomy confirmed massive intra-abdominal hemorrhage from the ruptured capsule of a 10-cm subserosal fibroid. A myomectomy was performed. Her postoperative recovery period was uneventful. This case is very rare, with fewer than 30 cases of hemoperitoneum secondary to rupture of fibroids having been reported in published works. It demonstrates how a benign and common condition, such as fibroids, can lead to an obstetric emergency that mimics a surgical abdomen requiring swift diagnosis and surgical intervention.

A comparison of the pregnancy outcomes between ultrasound-guided high-intensity focused ultrasound ablation and laparoscopic myomectomy for uterine fibroids: a comparative study

“…We noted that myomectomy during cesarean section increased postpartum hemorrhage, which requires further analysis so the obstetrical procedures can be improved. The rate of uterine rupture that can be attributed to LM was 1.0%; thus, spontaneous uterine rupture seems to be rare after LM [19,[22][23][24][25][26]. Previous literature has not reported the incidence of uterine rupture after USgHFIU ablation.…”

Enlarged uterine fibroid forming uterine diverticulum during pregnancy: a case report

“…As a result, the fibroid was dragged out of the uterine muscular axis, which led to the formation of a muscular hernia dragged into part of the endometrial mucosa of the uterus. Like these conditions, the results of ruptured degenerated fibroid or surface vessel cause hematoperitoneum even during pregnancy [15][16][17].…”

Hemoperitoneum following a Motor Vehicle Accident in a Patient with 20 Uterine Leiomyomas

“…Rupture of these veins may be due to increased venous pressure or increased intra-abdominal pressure, caused by conditions such as menstruation or pregnancy, or secondary to actions of heavy lifting [4]. Spontaneous arterial rupture may be caused by hypertension or large fibroids that overstretch arterial vessels [5]. On the other hand, traumatic rupture of leiomyoma can occur when an external traumatic force, such as a vehicle collision, induces a contrecoup-like mechanism within the pelvic organs.…”