A rare cause of hemoperitoneum in pregnancy

الملخص EN

Spontaneous rupture of uterine vein is a life-threatening unpredictable surgical emergency which had a high mortality rate in the past.

A full exploration of the uterus is of great importance to differentiate the cause of hemoperitoneum with an intact scar.

The key to save the mother and the baby in such case is an immediate laparotomy with quick delivery of fetus and timed blood replacement for the mother.

A twenty-nine-year-old Asian female, G2P1 at 35 weeks of gestation presented with labor pain.

She had gestational diabetes and history of previous Cesarean section.

Fetal monitor showed sudden severe fetal distress and hypotension (80/50 mmHg).

Scar rupture was suspected, emergency Cesarean section was performed.

Hemoperitoneum of approximately 600 ml of blood was removed.

The uterus was intact with no signs of rupture scar.

A live female baby was extracted.

Multiple large varicose veins were noted with active bleeding coming from the right varicosity.

Proximal and distal control sutures were applied and the right ascending branch of the uterine artery was ligated.

She was discharged on the 4th day post-Cesarean section.