Spontaneous hemoperitoneum in a term pregnancy mimicking uterine rupture: A case report

Background: Spontaneous hemoperitoneum during pregnancy is a rare occurrence and an obstetric emergency that presents with acute abdominal pain and shock. Case presentation: A 25-year-old primigravida at 38 weeks of gestation presented to the emergency unit in shock. She had a history of severe generalized abdominal and back pain of sudden onset, dizziness, and syncope with no history of trauma. Ultrasonography revealed free peritoneal fluid with a live intrauterine fetus. Blood transfusion, emergency laparotomy, and cesarean delivery were performed. A live female infant was delivered and admitted to the newborn unit. Postoperatively, the patient was started on antibiotics and analgesics and was stable at discharge. Conclusion: Spontaneous hemoperitoneum in pregnancy is a rare cause of maternal collapse, which may mimic uterine rupture and abruptio placentae. A high index of suspicion is required in women with acute onset of abdominal pain and abnormal maternal hemodynamics during pregnancy.