Uterine fibroids in pregnancy present with numerous complications. However, spontaneous rupture is a rare and potentially life-threatening event. We report a case of a 43-year-old multiparous woman who presented with hypovolemic shock secondary to a ruptured uterine fibroid 2 days after a spontaneous vaginal delivery. Emergency laparotomy confirmed massive intra-abdominal hemorrhage from the ruptured capsule of a 10-cm subserosal fibroid. A myomectomy was performed. Her postoperative recovery period was uneventful. This case is very rare, with fewer than 30 cases of hemoperitoneum secondary to rupture of fibroids having been reported in published works. It demonstrates how a benign and common condition, such as fibroids, can lead to an obstetric emergency that mimics a surgical abdomen requiring swift diagnosis and surgical intervention.
Keywords: intra-abdominal hemoperitoneum; leiomyoma; post-partum; pregnancy; spontaneous fibroid rupture.
© 2017 Japan Society of Obstetrics and Gynecology.