[Spontaneous Hemoperitoneum in Pregnancy]

Daniela Gonçalves, Gonçalves D, Marcília Teixeira, Teixeira M, Rodrigues R, Rosa Rodrigues, Jorge Braga
Acta medica portuguesa · 2019 · vol. 32(11) , pp. 730–732 · doi:10.20344/amp.11169 · PMID:31703187
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This case report describes spontaneous hemoperitoneum with hemorrhagic uterine foci in a pregnant woman with suspected endometriosis, highlighting the condition as a rare but serious complication requiring prompt intervention.

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This case report describes a pregnant woman at 34 weeks gestation who presented with sudden severe abdominal pain and was diagnosed with spontaneous hemoperitoneum. The patient had a history of suspected endometriosis, and surgical intervention during cesarean section revealed multiple hemorrhagic foci in the posterior uterine wall alongside a large volume of intra-abdominal blood. The authors note that while rare, this condition can occur in pregnancy, particularly in women with endometriosis, requiring prompt suspicion and expedite intervention to improve outcomes. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Endometriosis is a benign, estrogen-dependent chronic disorder. Pregnancy is considered to have a positive effect on endometriosis due to blockage of ovulation; however, evidence is emerging on the role of endometriosis not only in infertility but also in poor pregnancy outcomes. We present the case of a pregnant woman admitted for sudden and severe abdominal pain at 34 weeks gestation. Her previous medical history included endometriosis suspected by clinical symptoms and ultrasound. During cesarean section, performed by sustained fetal bradycardia, a large volume hemoperitoneum and multiple hemorrhagic foci in the posterior uterine wall were detected. Although rare, spontaneous hemoperitoneum may occur in pregnancy, especially in women with endometriosis. Thus, a prompt suspicion and expedite intervention are needed to improve maternal and fetal outcomes.
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Spontaneous Hemoperitoneum in Pregnancy DOI: https://doi.org/10.20344/amp.11169Keywords: Endometriosis, Hemoperitoneum, Pregnancy, Pregnancy ComplicationsAbstract Endometriosis is a benign, estrogen-dependent chronic disorder. Pregnancy is considered to have a positive effect on endometriosis due to blockage of ovulation; however, evidence is emerging on the role of endometriosis not only in infertility but also in poor pregnancy outcomes. We present the case of a pregnant woman admitted for sudden and severe abdominal pain at 34 weeks gestation. Her previous medical history included endometriosis suspected by clinical symptoms and ultrasound. During cesarean section, performed by sustained fetal bradycardia, a large volume hemoperitoneum and multiple hemorrhagic foci in the posterior uterine wall were detected. Although rare, spontaneous hemoperitoneum may occur in pregnancy, especially in women with endometriosis. Thus, a prompt suspicion and expedite intervention are needed to improve maternal and fetal outcomes. Downloads Downloads Published How to Cite Issue Section License All the articles published in the AMP are open access and comply with the requirements of funding agencies or academic institutions. The AMP is governed by the terms of the Creative Commons ‘Attribution – Non-Commercial Use - (CC-BY-NC)’ license, regarding the use by third parties. It is the author’s responsibility to obtain approval for the reproduction of figures, tables, etc. from other publications. Upon acceptance of an article for publication, the authors will be asked to complete the ICMJE “Copyright Liability and Copyright Sharing Statement “(http://www.actamedicaportuguesa.com/info/AMP-NormasPublicacao.pdf) and the “Declaration of Potential Conflicts of Interest” (http:// www.icmje.org/conflicts-of-interest). An e-mail will be sent to the corresponding author to acknowledge receipt of the manuscript. After publication, the authors are authorised to make their articles available in repositories of their institutions of origin, as long as they always mention where they were published and according to the Creative Commons license.

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Condition tags

endometriosisinfertility

MeSH descriptors

Cesarean Section Cesarean Section Endometriosis Hemoperitoneum Pregnancy Complications, Hematologic Abdominal Pain Abdominal Pain Abdominal Pain Adult Adult Bradycardia Bradycardia Endometriosis Endometriosis Endometriosis Female Female Fetal Diseases Fetal Diseases Hemoperitoneum

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