Spontaneous hemoperitoneum in pregnancy due to endometriosis

Tesia G. Kim, Leanna S. Sudhof, Fong W. Liu, Scott A. Shainker

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Hemoperitoneum in pregnancy requires urgent evaluation. While spontaneous intraperitoneal bleeding is rare, ectopic endometrial tissue is a frequent cause of this event. Case: A 38-year-old woman with a history of endometriosis presented at 26 weeks gestation with 1 week of vague abdominal pain. Vital signs were within normal limits, and physical exam was notable for left-sided abdominal tenderness. Imaging demonstrated simple free fluid in her pelvis, concern for a uterine fundal defect and an adjacent hematoma. Exploratory laparotomy revealed hemoperitoneum secondary to highly vascularized stage 4 endometriosis. After classical cesarean delivery, a supracervical hysterectomy with bilateral oophorectomy was performed due to ongoing global pelvic hemorrhage. Conclusion: Consider endometriosis as a cause of spontaneous hemoperitoneum in pregnancy. Obstetricians should be prepared for significant maternal morbidity when encountering such pathology.

Original languageEnglish (US)
Pages (from-to)124-127
Number of pages4
JournalJournal of Endometriosis and Pelvic Pain Disorders
Volume12
Issue number3-4
DOIs
StatePublished - Sep 1 2020
Externally publishedYes

Keywords

  • Imaging
  • endometriosis
  • laparotomy
  • medical treatment
  • pain
  • pelvic adhesions
  • surgical treatment

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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