Conservative management of disseminated intravascular coagulation caused by uterine leiomyoma degeneration in pregnancy: Case report and review.
Tsubasa Ito, Hiroaki Soyama, Arata Fujimoto et al.
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Case in brief
A 35-year-old woman at 25 weeks’ gestation presented with lower abdominal pain and a tender 6.5 cm uterine leiomyoma; fetal well-being and placental appearance were normal on ultrasonography. Subcutaneous bleeding and laboratory evidence of significant coagulopathy developed. MRI showed progressive degeneration localized to the leiomyoma’s subserosal component, and the coagulopathy was attributed to this degeneration. It resolved after transfusion therapy, and she was discharged 6 days after admission. At 38 weeks, she underwent elective cesarean delivery with concurrent myomectomy; mother and neonate were discharged in stable condition without complications.
What made this case unusual
The case describes DIC attributed to a degenerating uterine leiomyoma during pregnancy, with MRI localizing progressive degeneration to its subserosal component.
Diagnostic / clinical pearl
In a pregnant patient with a tender degenerating leiomyoma, new bleeding and coagulopathy should prompt consideration of leiomyoma-associated consumptive coagulopathy; MRI helped localize the degeneration in this case.
Why it matters
The reported coagulopathy resolved with transfusion therapy, and pregnancy continued to elective delivery without termination.