A Rare Case of Vaginal Myomectomy in Post-Partum Severe Hemorrhage Caused by a Submucosal Myoma

Myoma is the most common benign tumor of the female genital tract. The incidence of myoma increases with age. It mostly presents in the fifth decade of life. Since myoma is often asymptomatic and incidentally diagnosed, the true prevalence is unknown. This tumor may also become symptomatic and affect women’s quality of life. This study was performed to report a rare case of vaginal myomectomy in post-partum severe hemorrhage caused by a submucosal myoma.

A 39-year-old G2P1 woman with previous cesarean section and decreased fetal movement at 38th week of gestation was hospitalized. In sonography and biophysical profile, due to fetal compromised, pregnancy was terminated. After delivery of fetus, a submucosal myoma (12 × 12 cm) was protruded through cervical canal. Massive hemorrhage occurred and then vaginal myomectomy was done and the bed of myoma was packed with two long gauzes that removed after one day.

Vaginal myomectomy after natural vaginal delivery or possibly during cesarean section is a safe and reliable method to remove submucosal myomas especially large myomas and decrease the risk of complications and costs of re-surgery. Due to the increased risk of hemorrhage, it is better to conduct this surgery in third-level referral hospitals.