Spontaneous severe haemoperitoneum in the third trimester leading to intrauterine death: case report.

Case Reports in Obstetrics and Gynecology
Harriet WilliamsonIsmail M Hassan

Abstract

Spontaneous haemoperitoneum during pregnancy is a rare but potentially catastrophic cause of acute abdominal pain. A healthy 37-year-old primigravida presented with acute abdominal pain and hypovolaemic shock at 37-weeks gestation. An emergency caesarean section was indicated on the clinical suspicion of placental abruption. However, an ultrasound scan confirmed the absence of a fetal heartbeat, and, in light of the mother's haemodynamic stability, a vaginal delivery was deemed most appropriate. Subsequent imaging, due to deterioration over the following 24-hours, revealed a large heterogenous haematoma within the pelvic cavity, which was later found to be caused by severe pelvic endometriosis. Despite fertility problems associated with severe endometriosis, advanced assisted reproductive technology enables more of these patients to become pregnant, highlighting the need to be aware of this rare complication in pregnancy.

References

Jul 25, 1992·Lancet·B Loevinsohn
May 1, 1987·Biochimie·J Pérez-RodríguezI Núñez de Castro
Apr 1, 1987·American Journal of Obstetrics and Gynecology·M R FoleyF P Zuspan
Oct 1, 1996·Acta Obstetricia Et Gynecologica Scandinavica·Y MizumotoI Nagata
May 25, 2006·Journal of Molecular Endocrinology·J J Brosens, B Gellersen
Apr 25, 2007·Human Reproduction·Ivo A BrosensMarc Dhont

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Citations

Oct 10, 2015·Human Reproduction Update·Umberto Leone Roberti MaggioreMassimo Candiani

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