Endometriosis is a risk factor for spontaneous hemoperitoneum during pregnancy

Idiopathic Spontaneous Hemoperitoneum During Early Postpartum Period: Case Report

“…During pregnancy, spontaneous hemoperitoneum may occur in the second half of pregnancy, at labor, and occasionally during the early postpartum period; and endometriosis is a major risk factor for this condition. 5 Our case is a very rare case of ISH in the early postpartum period without an identifiable source of bleeding. In addition, we suppose that endometriotic foci or an omental band, which detached from these foci, or ectopic decidualization could be the cause for the bleeding.…”

“…5 Operation should be started by a median incision, however the incision line may be extended superiorly since the bleeding focus may be anywhere in the abdomen. However, it should be kept in mind that, in rare instances the surgeon may not find a bleeding focus.…”

Abdominopelvic Complications of Endometriosis

“…Inoue et al (1992) have suggested two possible explanations for the involvement of endometriosis: (i) chronic inflammation due to endometriosis may make utero-ovarian vessels more friable; (ii) the resultants adhesions may give further tension to these vessels when the uterus is enlarged during pregnancy. Invasiveness of severe endometriosis has been suggested as a reason for this entity, but Brosens et al (2009) found no apparent correlation between spontaneous hemoperitoneum in pregnancy and stage of endometriosis.…”

“…The condition is most common during the third trimester of pregnancy. Endometriosis is considered a major risk factor (Brosens et al, 2009). …”

“…Abdominal ultrasound examination does not reveal signs of placental abruption and fail to diagnose intraperitoneal bleeding as cause of acute pain. Transvaginal ultrasound and computerized tomography scans sometimes indicate the presence of intraperitoneal free fluid, but in most cases the diagnosis is only established at laparotomy (Brosens et al, 2009). Preoperatively other potential diagnoses are placental abruption, uterine rupture, HELLP syndrome, abdominal pregnancy or rupture of the liver or spleen (Grunewald & Jördens, 2010).…”