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Spontaneous Expulsion of Intramural Fibroid Six Weeks after Emergency Caesarean Section.

Sagoo B, Ng KY, Ghaleb G, Brown H - Case Rep Obstet Gynecol (2015)

Bottom Line: At 34 + 5 weeks, there were reduced fetal movements and a pathological CTG.She was given antibiotics and ferrous sulphate.When stable, she was discharged.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics & Gynaecology, London North West Healthcare NHS Trust, UK.

ABSTRACT
We present a thirty-six-year-old woman with a high risk pregnancy, complicated by multiple congenital anomalies, severe hyperemesis, a pulmonary embolus, and a large intramural fibroid. This fibroid grew in size during the pregnancy. At 34 + 5 weeks, there were reduced fetal movements and a pathological CTG. A live infant was delivered by an emergency cesarean section. Five weeks postpartum, she presented with abdominal pain, offensive vaginal discharge, and fevers. She was given antibiotics and ferrous sulphate. An abdominal ultrasound showed an 11 × 12 × 9 cm fibroid with a coarse degenerative appearance. Clinically, she showed signs of sepsis; a CT scan and laparotomy performed under general anesthetic did not find any collections as a source of sepsis. When stable, she was discharged. She re-presented two days later with a large mass (necrotic fibroid) in her vagina. This is the first case of spontaneous expulsion of fibroid six weeks after caesarean section. Presentation of pain and fever after the delivery may be due to red degeneration of the fibroid, caused by diminished blood supply, ischaemia, and necrosis. This case highlights the importance of considering fibroids as a cause for abdominal pain during and after pregnancy, even up to 6 weeks after delivery.

No MeSH data available.


Related in: MedlinePlus

Large necrotic fibroid which was expelled with a long pedicle hanging from the uterine fundus, approximately six weeks after an emergency caesarean section.
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fig1: Large necrotic fibroid which was expelled with a long pedicle hanging from the uterine fundus, approximately six weeks after an emergency caesarean section.

Mentions: Two days after discharge from hospital, she presented complaining of a mass in her vagina. On examination, a large fleshy vaginal mass was protruding from her vagina with no obvious bleeding or discharge; after consenting for an examination under anaesthesia, she was taken to theatre, where the mass was removed. In theatre, a large necrotic fibroid was identified and removed through the vagina by twisting off the long pedicle that was hanging from the uterine fundus (Figure 1, picture with consent from patient).


Spontaneous Expulsion of Intramural Fibroid Six Weeks after Emergency Caesarean Section.

Sagoo B, Ng KY, Ghaleb G, Brown H - Case Rep Obstet Gynecol (2015)

Large necrotic fibroid which was expelled with a long pedicle hanging from the uterine fundus, approximately six weeks after an emergency caesarean section.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4563065&req=5

fig1: Large necrotic fibroid which was expelled with a long pedicle hanging from the uterine fundus, approximately six weeks after an emergency caesarean section.
Mentions: Two days after discharge from hospital, she presented complaining of a mass in her vagina. On examination, a large fleshy vaginal mass was protruding from her vagina with no obvious bleeding or discharge; after consenting for an examination under anaesthesia, she was taken to theatre, where the mass was removed. In theatre, a large necrotic fibroid was identified and removed through the vagina by twisting off the long pedicle that was hanging from the uterine fundus (Figure 1, picture with consent from patient).

Bottom Line: At 34 + 5 weeks, there were reduced fetal movements and a pathological CTG.She was given antibiotics and ferrous sulphate.When stable, she was discharged.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics & Gynaecology, London North West Healthcare NHS Trust, UK.

ABSTRACT
We present a thirty-six-year-old woman with a high risk pregnancy, complicated by multiple congenital anomalies, severe hyperemesis, a pulmonary embolus, and a large intramural fibroid. This fibroid grew in size during the pregnancy. At 34 + 5 weeks, there were reduced fetal movements and a pathological CTG. A live infant was delivered by an emergency cesarean section. Five weeks postpartum, she presented with abdominal pain, offensive vaginal discharge, and fevers. She was given antibiotics and ferrous sulphate. An abdominal ultrasound showed an 11 × 12 × 9 cm fibroid with a coarse degenerative appearance. Clinically, she showed signs of sepsis; a CT scan and laparotomy performed under general anesthetic did not find any collections as a source of sepsis. When stable, she was discharged. She re-presented two days later with a large mass (necrotic fibroid) in her vagina. This is the first case of spontaneous expulsion of fibroid six weeks after caesarean section. Presentation of pain and fever after the delivery may be due to red degeneration of the fibroid, caused by diminished blood supply, ischaemia, and necrosis. This case highlights the importance of considering fibroids as a cause for abdominal pain during and after pregnancy, even up to 6 weeks after delivery.

No MeSH data available.


Related in: MedlinePlus