Endometriosis-Related Hemoperitoneum in Pregnancy: A Diagnosis to Keep in Mind.

Mauro Cozzolino, Serena Corioni, Luana Maggio, Flavia Sorbi, Secondo Guaschino, Massimiliano Fambrini
Ochsner journal · 2015 · vol. 15(3) , pp. 262–4 · PMID:26413000 · PMC4569160 · W2190746595
article OA: green CC0 ⤵ 19 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report describes a pregnant patient who experienced spontaneous hemoperitoneum, leading to ovarian laceration requiring an emergency cesarean section and annessiectomy.

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Abstract

BACKGROUND: Endometriosis is an important gynecologic clinical entity, pathologically defined by the ectopic presence of endometrium and frequently associated with pelvic pain, that affects approximately 10% of females of reproductive age. A rare but severe complication of endometriosis during pregnancy is spontaneous hemoperitoneum in pregnancy (SHiP), severe intraabdominal bleeding that can be life threatening. CASE REPORT: We present the case of a patient with SHiP at 29 weeks of pregnancy. A supraumbilical midline laparotomy was performed, and pelvic exploration revealed a lacerated and bleeding right ovary. Right annessiectomy was performed, and a cesarean section was performed because hemostasis was not achievable. A healthy baby was born, and hemostasis was finally achieved. CONCLUSION: We believe that in gravid females with a history of endometriosis, severe abdominal pain, and a reduction of hemoglobin, physicians should always suspect SHiP. Because SHiP is a life-threatening condition for both the mother and the baby, a prompt diagnosis must lead to prompt treatment.

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endometriosis

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