{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T14:31:49Z","timestamp":1793370709027,"version":"4.5.0"},"reference-count":18,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Case Rep"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>Uterine fibroids are the most common benign gynecologic tumors; in pregnancy, degeneration may occur but is uncommon, whereas spontaneous rupture is an exceedingly rare complication. We present the case of a 43-year-old woman, gravida 2 para 2, at 17\u2009weeks and 6\u2009days of gestation, who was admitted with progressive abdominal pain and distension. Imaging revealed a large degenerating intramural fibroid with hemoperitoneum and a focal contour defect, raising concern for rupture. Despite stable vital signs, the patient experienced spontaneous abortion during hospitalization. Persistent abdominal pain and imaging findings warranted exploratory laparotomy, which revealed approximately 2\u2009L of hemoperitoneum and a ruptured, necrotic fibroid. A uterine-sparing myomectomy was performed, and histopathology confirmed infarct-type degeneration with extensive hemorrhage and necrosis. The postoperative course was uneventful, and the patient was discharged in good condition. This case underscores that fibroid rupture in pregnancy may evolve subacutely, with preserved hemodynamics, and should be considered in pregnant patients with ongoing abdominal pain and degenerating myomas. Prompt recognition and timely surgical intervention are critical for favorable outcomes and uterine preservation.<\/jats:p>","DOI":"10.1177\/11795476251390171","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T07:19:46Z","timestamp":1761203986000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Pregnancy Complicated by Ruptured Degenerating Leiomyoma and Hemoperitoneum: Case Report"],"prefix":"10.1177","volume":"18","author":[{"given":"Bahar","family":"Farshidfar","sequence":"first","affiliation":[{"name":"Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3804-9531","authenticated-orcid":false,"given":"Keihan","family":"Shabankhani","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narjes","family":"Mohammadi","sequence":"additional","affiliation":[{"name":"Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aghdas","family":"Ebadi Jamkhane","sequence":"additional","affiliation":[{"name":"Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2278-3021","authenticated-orcid":false,"given":"Mohammadhossein","family":"Esfahani","sequence":"additional","affiliation":[{"name":"Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp2309623"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.99"},{"issue":"6","key":"e_1_3_3_4_2","article-title":"Practice bulletin No. 228: management of symptomatic uterine leiomyomas","volume":"137","author":"American College of Obstetricians and Gynecologists","year":"2021","unstructured":"American College of Obstetricians and Gynecologists. Practice bulletin No. 228: management of symptomatic uterine leiomyomas. Obstet Gynecol. 2021;137(6):e100-e115.","journal-title":"Obstet Gynecol"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S51083"},{"issue":"1","key":"e_1_3_3_6_2","first-page":"20","article-title":"Contemporary management of fibroids in pregnancy","volume":"3","author":"Lee HJ","year":"2010","unstructured":"Lee HJ, Norwitz ER, Shaw J. Contemporary management of fibroids in pregnancy. Rev Obstet Gynecol.2010;3(1):20-27.","journal-title":"Rev Obstet Gynecol"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.3564"},{"issue":"3","key":"e_1_3_3_8_2","first-page":"206","article-title":"Evaluation of red degeneration of uterine leiomyoma with susceptibility-weighted MR imaging","volume":"17","author":"Takeuchi M","year":"2018","unstructured":"Takeuchi M, Matsuzaki K, Bando Y, Harada M. Evaluation of red degeneration of uterine leiomyoma with susceptibility-weighted MR imaging. 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