Ascites in puerperium: a rare case of atypical pseudo-Meigs' syndrome complicating the puerperium

Giuseppe Ricci, Stefania Inglese, Alberto Candiotto, Gianpaolo Maso, Monica Piccoli, Salvatore Alberico, Secondo Guaschino
Archives of gynecology and obstetrics · 2009 · vol. 280(6) , pp. 1033–1037 · doi:10.1007/s00404-009-1041-0 · PMID:19322576 · W1996756341
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This case report describes the first instance of atypical pseudo-Meigs' syndrome, characterized by puerperal ascites and elevated CA125 levels secondary to a uterine leiomyoma without pleural effusion.

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Abstract

PURPOSE: We report the case of puerperal ascites, associated with elevated CA125 levels and secondary to a uterine myoma. The literature on pseudo-Meigs' syndrome associated with pregnancy was reviewed. CASE: A 35-year-old woman complained of abdominal distension 2 days after a spontaneous vaginal delivery. A mass of 5 cm in the right uterine corner had been detected during the first trimester ultrasound and had been diagnosed as subserosal myoma. Physical examination and ultrasound revealed massive ascites. Computed tomography confirmed ascites and laboratory investigations showed CA125 raised levels. Cytology of ascitic fluid resulted negative for malignancy. A laparotomy was performed and a large pedunculated myoma was removed. A final diagnosis of atypical pseudo-Meigs' syndrome was performed, being computed tomography and chest X-ray negative for pleural effusion. CONCLUSIONS: To the best of our knowledge, this is the first case of pseudo-Meigs' syndrome caused by a uterine leiomyoma described in puerperium and without hydrothorax. Though ascites is very rare in obstetrics, it should be considered when evaluating puerperal patients complaining of abdominal distension.

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MeSH descriptors

Ascites Leiomyoma Meigs Syndrome Uterine Neoplasms Adult Ascites Ascites Ascites Ascites CA-125 Antigen CA-125 Antigen Female Humans Laparotomy Leiomyoma Leiomyoma Leiomyoma Leiomyoma Meigs Syndrome Meigs Syndrome

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