Department of Obstetrics and Gynecology, Women and Children's Hospital of Ningbo University, Ningbo, Zhejiang, China.
J Int Med Res. 2024 Oct;52(10):3000605241285316. doi: 10.1177/03000605241285316.
Most persistent symptoms of pseudo-Meigs' syndrome (PMS) are alleviated by surgical tumor removal. The present case report suggests that PMS may present with ascites and hypercoagulation and that emergency anticoagulation can improve the patient's condition. We herein describe a postpartum woman with an acute presentation including abdominal pain, ascites, postpartum hemorrhage, and degeneration of a large uterine fibroid. Initial evaluation revealed unexpected massive ascites, pleural effusion, a highly elevated D-dimer level, and a moderately elevated CA125 level. Following anticoagulation therapy, the ascites, abdominal pain, and pleural effusion resolved. There was no recurrence of these symptoms during follow-up, although the large degenerating uterine fibroid and mildly elevated serum CA125 level persisted. Postoperatively, pathological analysis confirmed leiomyoma, the patient's CA125 level returned to normal, and the ascites resolved, meeting the diagnostic criteria for PMS. Further studies are needed to determine whether a hypercoagulable state is common in pregnant patients with PMS and to develop strategies to improve outcomes.
大多数假性梅格斯综合征（PMS）的持续症状可通过手术切除肿瘤得到缓解。本病例报告提示，PMS 可能表现为腹水和高凝状态，紧急抗凝治疗可改善患者的病情。本文描述了一位产后女性的急性表现，包括腹痛、腹水、产后出血和巨大子宫肌瘤变性。初步评估显示出意外的大量腹水、胸腔积液、D-二聚体水平显著升高和 CA125 水平中度升高。抗凝治疗后，腹水、腹痛和胸腔积液得到缓解。在随访期间，这些症状没有复发，尽管仍存在大的变性子宫肌瘤和轻度升高的血清 CA125 水平。术后病理分析证实为平滑肌瘤，患者的 CA125 水平恢复正常，腹水消退，符合 PMS 的诊断标准。需要进一步研究以确定 PMS 孕妇是否普遍存在高凝状态，并制定改善结局的策略。
