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CC BY-NC-ND 4.0 · AJP Rep 2024; 14(04): e250-e253
DOI: 10.1055/a-2434-5650
Case Report

Hemorrhaging Uterine Fibroid Leading to Emergent Early Term Cesarean Delivery: A Case Report

Nicholas Racchi 
1   Department of Obstetrics and Gynecology, TriHealth-Good Samaritan Hospital, Cincinnati, Ohio
,
Lisa Bird
1   Department of Obstetrics and Gynecology, TriHealth-Good Samaritan Hospital, Cincinnati, Ohio
,
Samantha Mullan
2   Division of Maternal-Fetal Medicine, TriHealth-Good Samaritan Hospital, Cincinnati, Ohio
,
William Schnettler
2   Division of Maternal-Fetal Medicine, TriHealth-Good Samaritan Hospital, Cincinnati, Ohio
,
Nanci Billock
1   Department of Obstetrics and Gynecology, TriHealth-Good Samaritan Hospital, Cincinnati, Ohio
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Abstract

Background The incidence of uterine leiomyomas, or fibroids, affecting pregnant individuals is estimated to be 10%, but there are no guidelines or recommendations for fetal or maternal surveillance in pregnancies affected by them. Risks associated with fibroids during pregnancy include potential for pain, preterm birth, fetal growth restriction, higher cesarean delivery rate, fetal malpresentation, placenta abruption, and postpartum hemorrhage.

Case Presentation This case describes a 26-year-old gravida 1 para 0 who presented at early term for severe abdominal pain and was found to have acute abdomen accompanied by a nonreassuring fetal heart rate tracing. With emergent cesarean delivery, it was found that the patient was hemorrhaging from a ruptured vessel of a pedunculated fibroid and myomectomy was subsequently performed.

Conclusion While rare, hemorrhage from a uterine fibroid should be considered a part of the differential diagnosis of abdominal pain in pregnant patients with fibroids, particularly when accompanied by concurrent indicators such as free fluid, hypotension/tachycardia, or concerning changes in fetal heart rate, especially in a patient without risk factors for uterine rupture.

Keywords

leiomyoma - hemorrhage - uterine fibroid - cesarean delivery - acute abdomen


Publication History

Received: 31 July 2024

Accepted: 04 August 2024

Accepted Manuscript online:
03 October 2024

Article published online:
22 October 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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