Spontaneous hemoperitoneum in a 29-week pregnancy with a history of endometriosis: A case report and review of the literature


Mehdiyev S., Tanoglu F. B., ALTUNCU E. D., Oral E.

International Journal of Gynecology and Obstetrics, cilt.169, sa.1, ss.31-37, 2025 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 169 Sayı: 1
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1002/ijgo.16006
  • Dergi Adı: International Journal of Gynecology and Obstetrics
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, CINAHL, EMBASE, Gender Studies Database, Public Affairs Index
  • Sayfa Sayıları: ss.31-37
  • Anahtar Kelimeler: assisted reproductive technology, endometriosis, hemoperitoneum, maternal morbidity, perinatal mortality, pregnancy, surgery
  • Bezmiâlem Vakıf Üniversitesi Adresli: Evet

Özet

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.