Endometriosis-related spontaneous hemoperitoneum in pregnancy (SHiP): report of two cases and review of the literature

Géraldine Brichant, Noémie Laurent, Faouzi Hamra, Linda Tebache, Michelle Nisolle
In: EGO: European Gynecology and Obstetrics, 1 (1), 24-26 (2019) · 2019 · W2986171346
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This paper presents two cases of endometriosis-associated spontaneous hemoperitoneum in pregnancy, detailing surgical interventions and reviewing the literature on this rare condition.

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This paper reports two cases of spontaneous hemoperitoneum in pregnancy (SHiP) occurring during delivery, characterized by severe abdominal pain and hypovolemic shock. Both patients had a prior history of endometriosis, with one case involving rupture of the uterine venous plexus managed via adnexectomy and the other involving uterine artery rupture treated with suturing. The authors review existing literature to highlight endometriosis as a major risk factor for this rare and life-threatening complication. This paper is centrally about endometriosis — specifically its role as a risk factor for spontaneous hemoperitoneum in pregnancy.

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Abstract

Spontaneous hemoperitoneum in pregnancy (SHiP) is a rare but life-threatening complication, for both the mother and the fetus. Its exact incidence is unknown. Several pathophysiological mechanisms have been suggested. However, the etiology of SHiP remains unknown. Endometriosis, whose incidence is increasing, is currently recognized as a major risk factor in its development. We report the case of a patient with spontaneous rupture of the right uterine venous plexus revealed by a severe abdominal pain during delivery, and another case with spontaneous rupture of the right uterine artery revealed by hypovolemic shock and fetal distress. In both patients, exploratory laparotomy revealed hemoperitoneum and active bleeding. Hemostasis and hemodynamic stability were obtained after right adnexectomy in the first case, and uterine artery suturing in the second. These two patients with a diagnosis of SHiP had both previously been diagnosed with and treated for endometriotic lesions.
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Keywords

Spontaneous hemoperitoneum; pregnancy; endometriosis; severe hypotension

Abstract

[en] Spontaneous hemoperitoneum in pregnancy (SHiP) is a rare but life-threatening complication, for both the mother and the fetus. Its exact incidence is unknown. Several pathophysiological mechanisms have been suggested. However, the etiology of SHiP remains unknown. Endometriosis, whose incidence is increasing, is currently recognized as a major risk factor in its development. We report the case of a patient with spontaneous rupture of the right uterine venous plexus revealed by a severe abdominal pain during delivery, and another case with spontaneous rupture of the right uterine artery revealed by hypovolemic shock and fetal distress. In both patients, exploratory laparotomy revealed hemoperitoneum and active bleeding. Hemostasis and hemodynamic stability were obtained after right adnexectomy in the first case, and uterine artery suturing in the second. These two patients with a diagnosis of SHiP had both previously been diagnosed with and treated for endometriotic lesions. Disciplines : Reproductive medicine (gynecology, andrology, obstetrics) BRICHANT, Géraldine ; Centre Hospitalier Universitaire de Liège - CHU > Département de gynécologie-obstétrique > Service de gynécologie-obstétrique (CHR) Laurent, Noémie ; Université de Liège - ULiège > Master spéc. méd. gén. (nouvelle formule 3 ans) Hamra, Faouzi ; Université de Liège - ULiège > Master spéc. gynéco.-obst. TEBACHE, Linda ; Centre Hospitalier Universitaire de Liège - CHU > Département de gynécologie-obstétrique > Service de gynécologie-obstétrique (CHR) NISOLLE, Michelle ; Centre Hospitalier Universitaire de Liège - CHU > Département de gynécologie-obstétrique > Service de gynécologie-obstétrique (CHR) Language : English Title : Endometriosis-related spontaneous hemoperitoneum in pregnancy (SHiP): report of two cases and review of the literature Publication date : 2019 Journal title : EGO: European Gynecology and Obstetrics Volume : 1 Issue : 1 Pages : 24-26 Available on ORBi : since 30 October 2019

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endometriosis

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