Spontaneous hemoperitoneum in pregnancy due to rupture of uterine vessels in woman with endometriosis: a case report

Background. Spontaneous rupture of uterine vessels is a rare and life-threating event than can rarely occur during spontaneous and low-risk pregnancies. The definitive association between adverse obstetrical events and pelvic endometriosis is still under evaluation. We report a severe case of spontaneous hemoperitoneum in pregnancy (SHiP) due to a rupture of the uterine vessels related to decidualized endometriosis. Case presentation. A 38-year-old primigravida woman at 33 weeks of pregnancy with an uncomplicated pregnancy and a history of endometriosis was admitted to the emergency room of our Institution, due to a spontaneous rupture of the right uterine vessels. An alive and vital baby was delivered by hysterotomy. In order to achieve hemostasis, a total hysterectomy with bilateral salpingectomy was performed. Conclusions. In case of spontaneous rupture of uterine vessels and resulting hemoperitoneum, prompt diagnosis and treatment are the crucial points in order to minimize maternal and fetal/neonatal complications. Further studies are necessary in order to identify endometriosis as a possible cause of spontaneous rupture of uterine vessels in pregnancy.