Hypovolemic shock due to massive edema of a pedunculated uterine myoma after delivery.
Although most patients with uterine myomas are asymptomatic during pregnancy, profound enlargement of a pedunculated myoma has serious consequences. In the present case, gradual enlargement of a pedunculated myoma was observed throughout a woman's pregnancy, worsening after delivery and causing hypovolemic shock, without evidence of external or intra-abdominal hemorrhage. Laparotomy revealed a severely edematous myoma containing a large amount of blood. It is speculated that partial occlusion had obstructed venous return, but not arterial blood flow, which caused rapid enlargement of the myoma.
Koide
Keiko
K
Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan.
Sekizawa
Akihiko
A
Nakamura
Masamitsu
M
Matsuoka
Ryu
R
Okai
Takashi
T
D000328:Adult; D004487:Edema / Q000150:complications*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000150:complications* / Q000473:pathology; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic; D012769:Shock / Q000209:etiology*; D014594:Uterine Neoplasms / Q000150:complications* / Q000473:pathology