Spontaneous Hemoperitoneum in Advanced Maternal Age Pregnancy

Elizabeth Stiles, Linda Zambrano Guevara, Andrew Rubenstein
In: Journal of Clinical Gynecology and Obstetrics · 2025 · vol. 14(4) , pp. 195–198 · doi:10.14740/jcgo1544 · W4417226541
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Abstract

Spontaneous hemoperitoneum in pregnancy (SHiP) is a rare but serious condition. Risk factors include endometriosis, in vitro fertilization (IVF), prior pelvic surgeries, and advanced maternal age (AMA). We report a 41-year-old female at 36 weeks’ gestation who presented with severe abdominal pain and non-reassuring fetal heart rate. Urgent cesarean delivery (CD) revealed hemoperitoneum. Clear amniotic fluid pointed to an extra-uterine source: bleeding from the posterior uterine serosa. While prompt surgical intervention in this case ensured maternal-fetal safety, the potential value of imaging to improve earlier recognition and diagnosis is discussed. This case underscores the need to consider SHiP in pregnancies lacking other known risk factors and presenting with unexplained abdominal symptoms.
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Spontaneous Hemoperitoneum in Advanced Maternal Age Pregnancy DOI: https://doi.org/10.14740/jcgo1544Keywords: Advanced maternal age, Endometriosis, IVF, Ultrasound imagingAbstract Spontaneous hemoperitoneum in pregnancy (SHiP) is a rare but serious condition. Risk factors include endometriosis, in vitro fertilization (IVF), prior pelvic surgeries, and advanced maternal age (AMA). We report a 41-year-old female at 36 weeks’ gestation who presented with severe abdominal pain and non-reassuring fetal heart rate. Urgent cesarean delivery (CD) revealed hemoperitoneum. Clear amniotic fluid pointed to an extra-uterine source: bleeding from the posterior uterine serosa. While prompt surgical intervention in this case ensured maternal-fetal safety, the potential value of imaging to improve earlier recognition and diagnosis is discussed. This case underscores the need to consider SHiP in pregnancies lacking other known risk factors and presenting with unexplained abdominal symptoms. Published Issue Section License Copyright (c) 2025 The authors This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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