Acute renal failure following necrosis of a myoma in the puerperium

The case is presented of a 36-year-old secundipara with the uterine myoma and a mild form of EPH gestosis. She became icteric and anuric on the sixth day after a spontaneous vaginal delivery and an apparently uneventful early puerperium. Blood coagulation tests were characteristic of disseminated intravascular coagulation (DIC). Since it is postulated that the appearance of DIC could be connected with the probable necrosis of a preexisting uterine myoma, abdominal hysterectomy was performed on the 8th puerperal day. Because of a persisting acute renal failure with highly elevated BUN levels and creatinine, the patient was subjected to haemodialysis every day during the next 73 days. After 3 months of this treatment she was discharged from hospital with a reduced but satisfactory renal function. The pathogenesis of DIC and acute renal failure following necrosis of the uterine myoma is discussed.