Sloughing off of a cervical myoma after cesarean section: a case report.
BACKGROUND
Occasionally a submucous myoma is sloughed off during the puerperium, but it is seldom that the initial location of the myoma is identified before its expulsion.


METHODS
A 32-year-old, nulliparous woman with a cervical myoma underwent an elective cesarean section at 37 weeks. At surgery a cervical myoma was identified as not endophytic to the intrauterine cavity but exophytic to the uterine exterior and was left without any intervention. Part of the cervical myoma was sloughed off into the vagina after 16 days, and an abdominal myomectomy was performed for a refractory infection.


CONCLUSIONS
Comparison with analogous cases following intervention indicates that myoma degeneration due to blood supply depletion, uterine contractions and endometrial sparseness must be important factors in this phenomenon. When these conditions are met, a shallow, intramural myoma could be sloughed off in the puerperium.
Murakami
Takashi
T
Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan. tm@ob-gy.med.tohoku.ac.jp
Niikura
Hitoshi
H
Shima
Yuki
Y
Terada
Yukihiro
Y
Okamura
Kunihiro
K
D000328:Adult; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D049590:Postpartum Period; D011247:Pregnancy; D012075:Remission, Spontaneous; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000601:surgery; D014599:Uterus / Q000098:blood supply