Obstet Gynecol Sci.  2016 Nov;59(6):530-534. 10.5468/ogs.2016.59.6.530.

A case of spontaneous hemoperitoneum by uterine vessel rupture in pregnancy

• Jang JH
• Kyeong KS
• Lee S
• Hong SH
• Ji I
• Jeong EH

• KMID: 2378579
• DOI: http://doi.org/10.5468/ogs.2016.59.6.530

Abstract

A 27-year-old pregnant woman, para 1, was transferred to our hospital at 29+3 weeks of gestation complaining of abdominal pain. She was diagnosed with hemoperitoneum based on ultrasonography. An emergency laparotomy was performed, and the bleeding was confirmed to be caused by ruptured surface blood vessels on the uterine fundus. Hemostasis with compression was successfully performed to sustain the pregnancy, and the patient delivered a full-term baby. Spontaneous hemoperitoneum during pregnancy caused by rupture of uterine blood vessels is very rare. It requires rapid diagnosis and surgical treatment because it increases the morbidity of the fetus and mother. In most incidences of spontaneous hemoperitoneum during pregnancy, a cesarean delivery is performed along with a simultaneous emergency laparotomy. However, in this case, the pregnancy was maintained to full term after surgical hemostasis, which prevented neonatal complications due to premature birth.

Keyword

Hemoperitoneum; Pregnancy; Rupture; Uterine vessel

MeSH Terms

Abdominal Pain
Adult
Blood Vessels
Diagnosis
Emergencies
Female
Fetus
Hemoperitoneum*
Hemorrhage
Hemostasis
Hemostasis, Surgical
Humans
Incidence
Laparotomy
Mothers
Pregnancy*
Pregnant Women
Premature Birth
Rupture*
Ultrasonography

Figure

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  Fig. 1 (A) Active bleeding is seen from the uterine surface vessels (arrow). (B) Cross section (arrow) of the sutures between the myometrium and necrosis of the vessel wall boundary (arrow head), which could be due to the blocked blood flow.

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