<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1646-5830</journal-id>
<journal-title><![CDATA[Acta Obstétrica e Ginecológica Portuguesa]]></journal-title>
<abbrev-journal-title><![CDATA[Acta Obstet Ginecol Port]]></abbrev-journal-title>
<issn>1646-5830</issn>
<publisher>
<publisher-name><![CDATA[Euromédice, Edições Médicas Lda.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1646-58302021000200174</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Spontaneous vaginal expulsion of a large uterine leiomyoma 10 weeks after a cesarean delivery - case report]]></article-title>
<article-title xml:lang="pt"><![CDATA[Expulsão vaginal de leiomioma uterino 10 semanas após cesariana - caso clínico]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Borges]]></surname>
<given-names><![CDATA[Ana Catarina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vides]]></surname>
<given-names><![CDATA[Belisa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Correia]]></surname>
<given-names><![CDATA[Cátia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Saleiro]]></surname>
<given-names><![CDATA[Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Reis]]></surname>
<given-names><![CDATA[Isabel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital de Braga Serviço Ginecologia/Obstetrícia ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>06</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>06</month>
<year>2021</year>
</pub-date>
<volume>15</volume>
<numero>2</numero>
<fpage>174</fpage>
<lpage>178</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S1646-58302021000200174&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S1646-58302021000200174&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S1646-58302021000200174&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Uterine leiomyomas are the most frequently benign smooth muscle tumor of uterus in reproductive age women and may negatively affect fertility and pregnancy outcomes. True prevalence of leiomyomas in pregnancy seems to be underestimated and its growth pattern during pregnancy remains controversial. Despite most leiomyomas present in pregnancy as an asymptomatic incidental finding, it can manifest with pain or discomfort due to torsion or degeneration. Until now, few studies reported cases of postpartum spontaneous vaginal expulsion of leiomyomas. Here we present the progression of a large hybrid leiomyoma through pregnancy and its spontaneous vaginal expulsion 10-weeks after cesarean delivery.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Leiomyoma]]></kwd>
<kwd lng="en"><![CDATA[Postpartum]]></kwd>
<kwd lng="en"><![CDATA[Pregnancy]]></kwd>
<kwd lng="en"><![CDATA[Vaginal discharge]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Saleh]]></surname>
<given-names><![CDATA[HS]]></given-names>
</name>
<name>
<surname><![CDATA[Mowafy]]></surname>
<given-names><![CDATA[HE]]></given-names>
</name>
<name>
<surname><![CDATA[Hameid]]></surname>
<given-names><![CDATA[AAAE]]></given-names>
</name>
<name>
<surname><![CDATA[Sherif]]></surname>
<given-names><![CDATA[HE]]></given-names>
</name>
<name>
<surname><![CDATA[Mahfouz]]></surname>
<given-names><![CDATA[EM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Does Uterine Fibroid Adversely Affect Obstetric Outcome of Pregnancy?]]></article-title>
<source><![CDATA[Biomed Res Int]]></source>
<year>2018</year>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[De Vivo]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Mancuso]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Giacobbe]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Maggio Savasta]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[De Dominici]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Dugo]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Uterine myomas during pregnancy a longitudinal sonographic study]]></article-title>
<source><![CDATA[Ultrasound Obstet Gynecol]]></source>
<year>2011</year>
<volume>37</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>361-5</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vitale]]></surname>
<given-names><![CDATA[SG]]></given-names>
</name>
<name>
<surname><![CDATA[Tropea]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Rossetti]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Carnelli]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Cianci]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Management of uterine leiomyomas in pregnancy review of literature]]></article-title>
<source><![CDATA[Updates Surg]]></source>
<year>2013</year>
<volume>65</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>179-82</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Somigliana]]></surname>
<given-names><![CDATA[E.]]></given-names>
</name>
<name>
<surname><![CDATA[Vercellini]]></surname>
<given-names><![CDATA[P.]]></given-names>
</name>
<name>
<surname><![CDATA[Daguati]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fibroids and female reproduction: A critical analysis of the evidence]]></article-title>
<source><![CDATA[Hum. Reprod. Update]]></source>
<year>2007</year>
<volume>13</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>465-76</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Catherine Guo]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Segars]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The impact and management of fibroids for fertility an evidence-based approach]]></article-title>
<source><![CDATA[Obstet Gynecol Clin North Am]]></source>
<year>2012</year>
<volume>39</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>521-33</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stout]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Odibo]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Graseck]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Leiomyomas at routine second-trimester ultrasound examination and adverse obstetric outcomes]]></article-title>
<source><![CDATA[Obstet Gynecol]]></source>
<year>2010</year>
<volume>116</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>1056-63</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vlahos]]></surname>
<given-names><![CDATA[NF]]></given-names>
</name>
<name>
<surname><![CDATA[Theodoridis]]></surname>
<given-names><![CDATA[TD]]></given-names>
</name>
<name>
<surname><![CDATA[Partsinevelos]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Myomas and Adenomyosis: Impact on Reproductive Outcome]]></article-title>
<source><![CDATA[Biomed Res Int]]></source>
<year>2017</year>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Parazzini]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Tozzi]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Bianchi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pregnancy outcome and uterine fibroids]]></article-title>
<source><![CDATA[Best Pract Res Clin Obstet Gynaecol]]></source>
<year>2015</year>
<volume>34</volume>
<page-range>74-84</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vitagliano]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Noventa]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Sardo]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Saccone]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Gizzo]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Borgato]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Uterine fibroid size modications during pregnancy and puerperium evidence from the first systematic review of literature]]></article-title>
<source><![CDATA[Arch Gynecol Obstet]]></source>
<year>2018</year>
<volume>297</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>823-35</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chill]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Karavani]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Rachmani]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Dior]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Tadmor]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Sushan]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Growth pattern of uterine leiomyoma along pregnancy]]></article-title>
<source><![CDATA[BMC Women's Health]]></source>
<year>2019</year>
<volume>19</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>100</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Munro]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Critchley]]></surname>
<given-names><![CDATA[HO]]></given-names>
</name>
<name>
<surname><![CDATA[Broder]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Fraser]]></surname>
<given-names><![CDATA[IS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The FIGO Classification System ("PALM-COEIN") for causes of abnormal uterine bleeding in non-gravid women in the reproductive years, including guidelines for clinical investigation]]></article-title>
<source><![CDATA[Int J Gynaecol Obstet]]></source>
<year>2011</year>
<volume>113</volume>
<page-range>3-13</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gupta]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Manyonda]]></surname>
<given-names><![CDATA[IT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acute complications of fibroids]]></article-title>
<source><![CDATA[Best Pract Res Clin Obstet Gynaecol]]></source>
<year>2009</year>
<volume>23</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>609-17</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Joanna]]></surname>
<given-names><![CDATA[BD]]></given-names>
</name>
<name>
<surname><![CDATA[Pawel]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Jacek]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Spontaneous Vaginal Expulsion of the Uterine Myomas]]></article-title>
<source><![CDATA[Med Case Rep]]></source>
<year>2018</year>
<volume>4</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>68</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sagoo]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Bonnie Ng]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Ghaleb]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Brown]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Spontaneous Expulsion of Intramural Fibroid Six Weeks after Emergency Caesarean Section]]></article-title>
<source><![CDATA[Case Rep Obstet Gynecol]]></source>
<year>2015</year>
<volume>2015</volume>
<page-range>640570</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Zou]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Spontaneous expulsion of a huge cervical leiomyoma from the vagina after cesarean A case report with literature review]]></article-title>
<source><![CDATA[Medicine]]></source>
<year>2018</year>
<volume>97</volume>
<numero>33</numero>
<issue>33</issue>
</nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[De Cure]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Sullivan]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Robertson]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hallam]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Whale]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Spontaneous expulsion of large submucosal uterine fibroid without embolization - a case study]]></article-title>
<source><![CDATA[AJUM]]></source>
<year>2013</year>
<volume>16</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>37-40</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Thorpe-Beeston]]></surname>
<given-names><![CDATA[JG]]></given-names>
</name>
<name>
<surname><![CDATA[Sebireb]]></surname>
<given-names><![CDATA[NJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Spontaneous expulsion of submucous fibroid after preterm labour]]></article-title>
<source><![CDATA[BJOG]]></source>
<year>2002</year>
<volume>109</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>726-7</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
