Ascites in puerperium: a rare case of atypical pseudo-Meigs' syndrome complicating the puerperium

Purpose We report the case of puerperal ascites, associated with elevated CA125 levels and secondary to a uterine myoma. The literature on pseudo-Meigs’ syndrome associated with pregnancy was reviewed. Case A 35-year-old woman complained of abdominal distension 2 days after a spontaneous vaginal delivery. A mass of 5 cm in the right uterine corner had been detected during the Wrst trimester ultrasound and had been diagnosed as subserosal myoma. Physical examination and ultrasound revealed massive ascites. Computed tomography conWrmed ascites and laboratory investigations showed CA125 raised levels. Cytology of ascitic Xuid resulted negative for malignancy. A laparotomy was performed and a large pedunculated myoma was removed. A Wnal diagnosis of atypical pseudo-Meigs’ syndrome was performed, being computed tomography and chest X-ray negative for pleural eVusion. Conclusions To the best of our knowledge, this is the Wrst case of pseudo-Meigs’ syndrome caused by a uterine leiomyoma described in puerperium and without hydrothorax. Though ascites is very rare in obstetrics, it should be considered when evaluating puerperal patients complaining of abdominal distension.