Ectopic Decidualization Causing Massive Postpartum Intraperitoneal Hemorrhage

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A postpartum hemorrhage caused by ectopic decidualization with vascular intrusion into the left hypogastric artery was observed in a patient with prior endometriosis.

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Abstract

BACKGROUND: Spontaneous intraperitoneal hemorrhage during pregnancy or in the postpartum period is a rare but dangerous phenomenon. CASE: A 41-year-old gravida 3 para 1, 9 days postpartum, presented with lower abdominal pain and hypovolemia. Emergent laparotomy revealed massive intraperitoneal hemorrhage caused by ectopic decidualization with vascular intrusion into the left hypogastric artery in an area of previously documented endometriosis. CONCLUSION: Ectopic deciduosis is usually no more than a pathologic curiosity. In a pregnant patient with spontaneous intraperitoneal hemorrhage, however, it must be considered because it results in a high incidence of maternal and neonatal mortality.

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Condition tags

endometriosis

MeSH descriptors

Choristoma Decidua Hemorrhage Peritoneal Diseases Postpartum Period Adult Blood Transfusion Choristoma Electrocoagulation Endometriosis Endometriosis Endometriosis Fallopian Tubes Fallopian Tubes Female Hemorrhage Hemorrhage Humans Hysterectomy MEDLINE

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References (13)

Cited by (40)

Source provenance

europepmc
last seen: 2026-06-13T06:22:48.782012+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-05-13T22:15:12.369988+00:00
License: CC0 · commercial use OK