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Case report
Idiopathic spontaneous haemoperitoneum at 4 weeks gestation
  1. Emily O'Brien1,2,
  2. Rehan Feroz1 and
  3. Sona Jasani1
  1. 1 Obstetrics and Gynecology, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
  2. 2 Penn State College of Medicine, Hershey, Pennsylvania, USA
  1. Correspondence to Dr Sona Jasani; sjasani{at}pennstatehealth.psu.edu

Abstract

A 20-year-old nulliparous patient with acute-onset abdominal pain and imaging suggestive of haemoperitoneum was admitted for observation. Though, initially, haemodynamically stable, her clinical picture worsened throughout her hospitalisation and warranted two separate laparoscopies that revealed 1200 mL and 50 mL of haemoperitoneum, respectively, without an identifiable bleeding source. After serial β-human chorionic gonadotropin levels and ultrasound confirmation of a viable pregnancy 23 days later, the patient underwent a normal antenatal course and delivered a healthy infant at 37 weeks gestation. This unusual case highlights the need to consider spontaneous haemoperitoneum in pregnancy as a diagnosis, particularly in the setting of pregnancy of unknown location, even at an early stage of pregnancy.

  • pregnancy
  • reproductive medicine
  • ultrasonography
  • sexual health
  • obstetrics and gynaecology

https://doi.org/10.1136/bcr-2021-244470

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    Footnotes

    • Twitter @emily_obs

    • Contributors All authors have made substantial contributions to the work as listed below. RF contributed to the conception of the work, the analysis of data, drafting and critically revising the work, offering final approval of the version published and agreeing to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. EO’B offered substantial contributions to the design of the work, the analysis and interpretation of data, drafting and critically revising the work for important intellectual content, offering final approval of the version published and agreeing to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. SJ contributed to the conception of the work, the analysis of data, drafting and critically revising the work, offering final approval of the version published and agreeing to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer-reviewed.