Post-partum hemoperitoneum following uterine vessel rupture associated with endometriosis. Case report and review of the literature
DOI:
https://doi.org/10.18597/rcog.132Keywords:
Pregnancy, endometriosis, hemoperitoneum, pospartum hemorrhageAbstract
Objective: To undertake a review of the literature on the epidemiology, etiology, diagnosis and management of uterine vessel ruptures in pregnancy.
Materials and methods: A case of a 32 year old woman with spontaneous hemoperitoneum in the immediate post-partum period secondary to a rupture of superficial uterine vessels at Hospital Universitario Fundación Santa Fe, a high complexity institution that provides care to patients with private contributive health insurance coverage. Emergency laparotomy and hysterectomy were performed with a finding of endometrial tissue in the posterior aspect of the uterus and the posterior cul-de-sac, and active venous bleeding. A search of the literature was done in Medline/Pubmed, Ebsco, Ovid and ProQuest, using the terms "hemoperitoneum", "pregnancy", "uterine vessel rupture" and "endometriosis" with no language limitation and epidemiologic design, published since 1966 to this date.
Results: Out of 34 articles of interest, 13 were selected: 1 clinical practice guideline, 2 review articles and 10 case reports.
Conclusion: Hemoperitoneum in pregnancy, secondary to uterine vessel rupture is a rare complication of unclear etiology and non-specific clinical presentation. Management requires a multidisciplinary approach with early surgical intervention and correct intravascular volume replacement.
Author Biographies
Diego Portilla-Quevedo
Cristian Hernández-Giraldo
Piedad Sarmiento-Hernández
Andrea Zuluaga-Liberato
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