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International Journal of Gynecology and Obstetrics, vol.169, no.1, pp.31-37, 2025 (SCI-Expanded, Scopus)
Spontaneous hemoperitoneum in pregnancy (SHIP) is defined as sudden, nontraumatic intraperitoneal bleeding that occurs during pregnancy or up to 42 days postpartum. The incidence ranges between 4 and 4.9 per 100 000 births. Although seen rarely, it is associated with perinatal morbidity and mortality due to maternal hemodynamic instability. Endometriosis was shown to be present in 71% of SHIP cases. A 30-year-old primigravid woman with a spontaneous conception, at 29 weeks of gestation, presented to our obstetrics and gynecology emergency department with complaints of abdominal and back pain. In terms of her medical history, a laparoscopic cystectomy was performed in August 2022 due to a 90 mm × 50 mm endometrioma in the right ovary. However, deep endometriosis and adenomyosis were not observed. After decelerations appeared on the non-stress test, the repeat hemoglobin values dropped to 7.2 g/dL, with blood pressure at 70/50 mm Hg and a pulse rate of 95/min. The decision was made for laparotomy and emergency delivery of the baby. It is crucial to consider SHIP, especially in pregnant patients with a history of endometriosis surgery. Managing such high-risk cases in specialized centers and easily identifying predisposing factors for SHIP can lead to improved outcomes, despite its rarity and poor prognosis.