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Obstetrics and gynaecology
Spontaneous haemoperitoneum in the second trimester of pregnancy
  1. Karen Carlson and
  2. Sandy Montoya
  1. Ob Gyn, University of Nebraska Medical Center, Omaha, Nebraska, USA
  1. Correspondence to Dr Karen Carlson; kscarlson{at}unmc.edu

Abstract

This is a case of a spontaneous haemoperitoneum occurring in the second trimester of pregnancy which was managed with interventional radiology to avoid laparotomy and its potential consequences. We aim to raise awareness of this condition in pregnancy because the perinatal mortality rate is as high as 36%. Spontaneous haemoperitoneum in pregnancy (SHiP) has frequently been associated with vascular rupture from pre-existing endometriosis. Most cases of SHiP have been managed with laparotomy. However, transcatheter embolisation can impart lifesaving alternatives to more invasive interventions when caring for pregnant patients. More judicious use of imaging procedures may also help improve diagnostic and therapeutic pathways with SHiP. We recommend that high-risk pregnancies are managed in level IV regional perinatal healthcare centres, when possible, where subspecialists and alternative measures of management exist.

  • Pregnancy
  • Materno-fetal medicine
  • Radiology
  • Interventional radiology
  • Urinary and genital tract disorders

https://doi.org/10.1136/bcr-2023-258052

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: KC and SM. The following authors gave final approval of the manuscript: KC and SM.

    • 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.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

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