Hemoperitoneum during pregnancy with endometriosis; report of four\ncases

Background: Endometriosis is a chronic inflammatory gynecologic\ndisease. Problems associated with endometriosis include dysmenorrhea,\ndyspareunia, and infertility. While endometriosis does not generally\ncause complications during pregnancy, endometriosis clearly causes\ncomplications before pregnancy. Cases: We report four patients with\nendometriosis who developed a hemoperitoneum during pregnancy,\nsuggesting that endometriosis may be involved in the development of a\nhemoperitoneum. The patients were diagnosed with endometriosis during\nsurgery or underwent laparoscopic resection of endometriosis. There\nwere one hemoperitoneum that occurred in the second trimester and one\nhemoperitoneum occurred in the third trimester. Two hemoperitoneums\noccurred at the time of vaginal delivery. Conclusion: A spontaneous\nhemoperitoneum during pregnancy is a rare and life-threatening\ncondition because of the high maternal and fetal mortality rates. The\npresence of surgical scar tissue and deep infiltrated endometriotic\nlesions located under dense adhesions in the cul-de-sac could have been\navulsed by uterine contractions and pushing in labor.