Spontaneous Rupture of the Uterine Vessels in Pregnancy

Aziz U, Uzma Aziz, Anapurna Kulkarni, Aparna Kulkarni, Kulkarni A, Lazic D, Darko Lazic, J. Cullimore, John E Cullimore, Cullimore JE
Obstetrics and gynecology · 2004 · vol. 103(5) , pp. 1089–1091 · doi:10.1097/01.aog.0000121833.79081.c7 · PMID:15121618 · W2043244059
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-09 ⓘ

Massive hemoperitoneum caused by spontaneous rupture of the left uterine vessels associated with decidualized endometriosis occurred in a woman at 20 weeks of gestation.

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This case report describes a pregnant woman at 20 weeks gestation who presented with acute abdominal pain and hypovolemic shock due to spontaneous rupture of the left uterine vessels. Surgical intervention via immediate laparotomy revealed massive hemoperitoneum caused by the vascular rupture, which was associated with an adnexal mass identified as decidualized endometriosis. The fetus was delivered through hysterotomy, hemostasis was successfully achieved, and the patient recovered well following the procedure. Relevance to endometriosis: The paper explicitly links the catastrophic vascular event to decidualized endometriosis, identifying it as the underlying pathology in this rare complication of pregnancy.

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Abstract

In Brief BACKGROUND: Hemoperitoneum resulting from spontaneous rupture of the uterine vessels in pregnancy is rare and associated with high maternal and fetal mortality. CASE: A woman presented with acute abdominal pain and hypovolemic shock at 20 weeks of gestation. Immediate laparotomy revealed massive hemoperitoneum resulting from spontaneous rupture of the left uterine vessels associated with a left adnexal mass consisting of decidualized endometriosis. The fetus was delivered by hysterotomy, hemostasis was achieved, and the woman made a good recovery. CONCLUSION: We report a case of hemoperitoneum in pregnancy that resulted from spontaneous rupture of the uterine vessels associated with decidualized endometriosis. Massive hemoperitoneum caused by rupture of the left uterine vessels associated with decidualized endometriosis occurred in a woman at 20 weeks of gestation.
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Background

Hemoperitoneum resulting from spontaneous rupture of the uterine vessels in pregnancy is rare and associated with high maternal and fetal mortality. CASE: A woman presented with acute abdominal pain and hypovolemic shock at 20 weeks of gestation. Immediate laparotomy revealed massive hemoperitoneum resulting from spontaneous rupture of the left uterine vessels associated with a left adnexal mass consisting of decidualized endometriosis. The fetus was delivered by hysterotomy, hemostasis was achieved, and the woman made a good recovery.

Conclusion

We report a case of hemoperitoneum in pregnancy that resulted from spontaneous rupture of the uterine vessels associated with decidualized endometriosis. Massive hemoperitoneum caused by rupture of the left uterine vessels associated with decidualized endometriosis occurred in a woman at 20 weeks of gestation. Copyright © 2004 The American College of Obstetricians and Gynecologists

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Condition tags

endometriosis

MeSH descriptors

Blood Vessels Hemoperitoneum Pregnancy Complications, Cardiovascular Uterus Adnexal Diseases Adnexal Diseases Adult Blood Vessels Endometriosis Endometriosis Female Hemoperitoneum Humans Pregnancy Pregnancy Complications, Cardiovascular Rupture, Spontaneous Uterus

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