Endometriosis-related spontaneous haemoperitoneum in pregnancy - case report and literature review

Y. Li, Liqun Sun, X. Zheng, S. Li, Jiaming Liu, Rongyuan Zheng
In: Clinical and Experimental Obstetrics & Gynecology · 2019 · vol. 46(2) , pp. 317–319 · doi:10.12891/ceog4558.2019 · W3028123886
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case report describes a pregnant woman with endometriosis who experienced spontaneous haemoperitoneum requiring emergency laparotomy due to active bleeding from uterine endometriotic lesions.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This paper reports a rare case of spontaneous haemoperitoneum in pregnancy (SHiP) in a 35-year-old woman who developed sudden abdominal pain at 33 weeks’ gestation, alongside a decrease in hemoglobin, fetal heart rate changes, and imaging evidence of free intraperitoneal fluid. After suspicion of placental abruption, an emergency midline laparotomy found 2,500 mL of blood and active bleeding originating from a purplish lesion that was confirmed as an endometriotic lesion on microscopy, and the patient underwent transfusion and recovered with delivery at postoperative day six. A key limitation is that diagnosis and bleeding source identification preoperatively remain difficult, with most origin and quantity only clarified at surgery, and the article is fundamentally a single-case report with literature context. Relevance to endometriosis: it describes endometriosis as the major risk factor for SHiP and documents bleeding specifically from endometriotic lesions during pregnancy, though the main focus is the SHiP case report and associated literature review rather than a broader mechanistic study.

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Abstract

Spontaneous haemoperitoneum in pregnancy (SHiP) is a rare disease that is associated with adverse pregnancy outcome. The authors present a case of a 35-year-old pregnant woman who developed spontaneous haemoperitoneum at 33 weeks of gestation. An emergency laparotomy was performed, which revealed massive haemoperitoneum with active bleeding from the endometriotic lesions at the right back of uterus. The authors wish to highlight this uncommon but potentially life-threatening condition, which requires early recognition and prompt surgical intervention to reduce morbidity and mortality.

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Condition tags

endometriosis

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