Puerperal Complications of a Retroplacental Uterine Leiomyoma.

Leiomyoma can be found concomitant with pregnancy and can cause complications during labor, delivery, and postpartum management. In the present case, a 26-year-old nulliparous patient at 39.4 weeks gestational age with a 12×9-cm retroplacental leiomyoma underwent a spontaneous vaginal delivery. Nine weeks after delivery, the patient presented with acute pain and vaginal bleeding. Immediate manual removal of the bulk of the leiomyoma tissue via vaginal approach was performed. Four weeks later, the patient returned for removal of the remaining tissue via hysteroscopic excision. This case demonstrates that a large retroplacental leiomyoma can be associated with both immediate and delayed postpartum complications, and it can be managed in a minimally invasive way.