Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
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 pureperium. 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 as 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.