Acute Hemorrhagic Shock from Prolapsing Myoma Requiring Emergent Surgical Management: A Case Report

Nicholas Stansbury, Jun Song, Erin Nelson

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Leiomyomas (fibroids) are common benign uterine tumors with varying symptomatology. Fibroids can prolapse, resulting in acute bleeding. Hem-orrhagic shock is an extremely rare but life-threatening complication of fibroids. CASE: A 40-year-old, mul-tiparous woman presented to the emergency department in acute hemorrhagic shock. She was hemodynamically unstable, with a heart rate of 167 and undetectable blood pressure. She was stabilized with transfusion of 3 units of packed red blood cells. Exam-ination revealed an enlarged uterus (to the umbilicus), 200 cc of bright red blood per vagina, and a 10-cm mass filling the vagina with no palpable cervix, consistent with a prolapsing fibroid. Ultrasound confirmed a 12×10-cm prolapsing fibroid. While in the emergency room she continued bleeding and required additional blood products. The patient was urgently taken to the operating room for surgical management. She under-went a total abdominal hysterectomy and required 1 unit of packed red blood cells and fresh frozen plasma intra-operatively. The postoperative period was uneventful, with complete recovery. CONCLUSION: Hemorrhagic shock from prolapsing fibroid is a rare, life-threatening complication of fi-broids. It should be considered in all patients with acute vaginal bleeding and discussed as a potential complication in patients with a known fibroid.

Original languageEnglish (US)
Pages (from-to)400-402
Number of pages3
JournalJournal of Reproductive Medicine
Issue number6
StatePublished - Dec 2021


  • Hemorrhagic shock
  • Leiomyomas
  • Pro-lapsing fibroid
  • Transfu-sion
  • Uterine fibroids
  • Uterine leiomyomas

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology


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