Conservative management of disseminated intravascular coagulation caused by uterine leiomyoma degeneration in pregnancy: Case report and review

OBJECTIVE: Disseminated intravascular coagulation (DIC) secondary to consumptive coagulopathy from a degenerative uterine leiomyoma (UL) is an exceptionally rare complication during pregnancy. CASE REPORT: A 35-year-old woman (gravida 2, para 0) presented at 25 weeks of gestation with lower abdominal pain. Ultrasonography confirmed fetal well-being and a normal placenta and identified a 6.5 cm UL associated with marked tenderness on physical examination. Although acetaminophen provided temporary pain relief, subcutaneous bleeding developed, and laboratory evaluation revealed significant coagulopathy. Magnetic resonance imaging demonstrated progressive degeneration of the UL, localized to the subserosal component. Therefore, DIC was attributed to the degenerative UL. The coagulopathy resolved following transfusion therapy, and the patient was discharged 6 days after admission. At 38 weeks of gestation, an elective cesarean section with concurrent myomectomy was performed. Both mother and neonate were discharged in stable condition without complications. CONCLUSION: This case highlights that conservative management without the need for pregnancy termination, may be a feasible and effective approach for DIC associated with degenerative UL during pregnancy.