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Case Studies | Obstetrics and Gynecology | India | Volume 11 Issue 10, October 2022

An Unusual Case of Idiopathic Spontaneous Hemoperitoneum in the First Trimester of Pregnancy

Dr. Megha Annaiah | Dr. Prema D'cunha

Abstract: Spontaneous hemoperitoneum in Pregnancy is an unprovoked, obstetric catastrophic event. It is defined as bleeding in the peritoneal cavity of non traumatic and noniatrogenic etiology in pregnant women. This dramatic pregnancy complication is associated with a high incidence of maternal as well as perinatal mortality and morbidity. Presenting a 33-year-old, G5P4L4, unregistered case, at 6 weeks and 5 days period of gestation, was referred from periphery hospital in view of sudden onset of severe acute pain abdomen associated with four episodes of vomiting and in hypovolaemic shock with a tense and distended abdomen. Gross hemoperitoneum with intrauterine gestational sac corresponding to 6 weeks and 2 days with evidence of no cardiac activity along large fibroid was showed in the abdominal scan. Immediate exploratory laparotomy revealed a 20-week gestational-size of subserosal fibroid. A myomectomy was performed. The exact source of the bleeding remained obscured even after careful exploration of abdominal organs, visceral arteries, and veins by surgical team. Diagnosis is difficult because of non-specific clinical picture and absence of main risk factors. Spontaneous hemoperitoneum in first trimester is a rare but life threatening condition and its etiology is yet poorly understood. Identifying and addressing the source of severe bleeding is very challenging.

Keywords: Spontaneous hemoperitoneum in pregnancy, SHiP

Edition: Volume 11 Issue 10, October 2022,

Pages: 1071 - 1072