{"paper_id":"f8fb6532-d7ca-4a61-9cf9-ba9b7cb252b7","body_text":"Abstract\nSpontaneous hemoperitoneum in pregnancy is a rare and challenging obstetric emergency. It can present as acute abdomen with features of hypovolemic shock and requires high index of suspicion for diagnosis as various obstetric and non-obstetric causes have similar presenting features. Here we present a case of primigravida at 33 weeks of gestation who presented with acute abdomen, signs of shock and a pathological trace on cardiotocogram. She underwent laparotomy and cesarean section in view of suspicion of abruption placentae. Intraoperatively there was hemoperitoneum of 600 ml with 750 g clots and a small venous bleeder on the posterior surface of the uterus which was secured with hemostatic sutures. Patient got discharged along with the baby on seventh postoperative day. Timely intervention is paramount in reducing maternal morbidity and mortality.\nSimilar content being viewed by others\nReferences\nAziz U, Kulkarni A, Lazic D, Cullimore JE. Spontaneous rupture of the uterine vessels in pregnancy. Obstet Gynecol. 2004;103(5):1089–91.\nLier MCI, Malik RF, van Waesberghe JHTM, Mass JW, van Rumpt-Van de Geest DA, et al. Spontaneous hemoperitoneum in pregnancy and endometriosis: a case series. BJOG. 2017;124(2):306–12. https://doi.org/10.1111/1471-0528.14371.\nLier MCI, Brosens IA, Mijatovic V, Habiba M, Benagiano G. Decidual bleeding as a cause of spontaneous hemoperitoneum in pregnancy and risk of preterm birth. Gynecol Obstet Invest. 2017;82(4):313–21. https://doi.org/10.1159/000468933.\nBrosens IA, Lier MC, Mijatovic V, Habiba M, Benagiano G. Severe spontaneous hemoperitoneum in pregnancy may be linked to in vitro fertilization in patients with endometriosis: a systematic review. Fertil Steril. 2016;106(3):692–703. https://doi.org/10.1016/j.fertnstert.2016.05.025.\nLier MCI, Malik RF, Ket JCF, Lambalk CB, Brosens IA, Mijatovic V. Spontaneous hemoperitoneum in pregnancy (SHiP) and endometriosis—a systematic review of the recent literature. Eur J Obstet Gynecol Reprod Biol. 2017;219:57–65. https://doi.org/10.1016/j.ejogrb.2017.10.012.\nAcknowledgements\nNone\nFunding\nNone.\nAuthor information\nAuthors and Affiliations\nContributions\nDN, AT and HS were involved in the management of the case; DN wrote the first manuscript. AT and HS revised the manuscript. DN, AT and HS approved the final version.\nCorresponding author\nEthics declarations\nConflict of interest\nThe author declares no conflict of interest.\nEthical Approval\nEthical approval is not required for case reports as per the Institutional Ethics Committee guidelines.\nInformed Consent\nInformed consent obtained from the patients and their identity was not disclosed.\nConsent for Publication\nWe hereby transfer, assign, or otherwise convey all copyright ownership, including any and all rights incidental thereto, exclusively to the journal, in the event that such work is published by the journal.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nDr. Deepthi Nayak is currently working as Senior Resident in Department of Obstetrics and Gynecology, JIPMER, Puducherry. She did her MBBS from Kasturba medical college, Manipal, Karnataka and MS Obstetrics and Gynecology from Jawaharlal Institute of postgraduate medical education and research, Puducherry.\nRights and permissions\nAbout this article\nCite this article\nNayak, D., Thangavel, A. & Sagili, H. Spontaneous Hemoperitoneum in Third Trimester of Pregnancy—an Enigma. J Obstet Gynecol India 72, 449–453 (2022). https://doi.org/10.1007/s13224-021-01522-w\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s13224-021-01522-w","source_license":"CC0","license_restricted":false}