title: Ascites in puerperium: a rare case of atypical pseudo-Meigs' syndrome complicating the puerperium.
abstract: OBJECTIVE
  We report the case of puerperal ascites, associated with elevated CA125 levels and secondary to a uterine myoma. The literature on pseudo-Meigs' syndrome associated with pregnancy was reviewed.
  
  
  METHODS
  A 35-year-old woman complained of abdominal distension 2 days after a spontaneous vaginal delivery. A mass of 5 cm in the right uterine corner had been detected during the first trimester ultrasound and had been diagnosed as subserosal myoma. Physical examination and ultrasound revealed massive ascites. Computed tomography confirmed ascites and laboratory investigations showed CA125 raised levels. Cytology of ascitic fluid resulted negative for malignancy. A laparotomy was performed and a large pedunculated myoma was removed. A final diagnosis of atypical pseudo-Meigs' syndrome was performed, being computed tomography and chest X-ray negative for pleural effusion.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first case of pseudo-Meigs' syndrome caused by a uterine leiomyoma described in puerperium and without hydrothorax. Though ascites is very rare in obstetrics, it should be considered when evaluating puerperal patients complaining of abdominal distension.
authors.affiliation: Department of Obstetrics and Gynecology, Institute for Maternal and Child Health IRCCS Burlo Garofolo, University of Trieste, Italy. ricci@burlo.trieste.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ricci
authors.forename: Stefania
authors.initials: S
authors.lastname: Inglese
authors.forename: Alberto
authors.initials: A
authors.lastname: Candiotto
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Maso
authors.forename: Monica
authors.initials: M
authors.lastname: Piccoli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Alberico
authors.forename: Secondo
authors.initials: S
authors.lastname: Guaschino