Abstract
A woman with five previous normal vaginal deliveries and a history of right salpingectomy for ectopic preg-nancyhas sudden pain in term labour, with epidural analgesia. A concurrent worsening of fetal heart rate pattern with bradycardia urges quick vacuum delivery. Maternal post-partum pain and hemoglobin (Hb) drop suggest intra-abdominal haemorrhage. The combination of sudden, strong intra-partum pain and fetal distress should raise the suspicion of intra-abdominal haemorrhage. After vaginal delivery an accurate follow-up is mandatory.
Highlights
The combination of sudden, strong intra-partum pain and fetal distress should raise the suspicion of intra-abdominal haemorrhage
Haemoperitoneum resulting from spontaneous rupture of utero-ovarian vessels during pregnancy and delivery is very rare, it is a life-threatening complication for mother and child
120 cases have been reported in literature, the majority (61%) directly related to labour [1]
Summary
Haemoperitoneum resulting from spontaneous rupture of utero-ovarian vessels during pregnancy and delivery is very rare, it is a life-threatening complication for mother and child. 120 cases have been reported in literature, the majority (61%) directly related to labour [1]. Maternal mortality rate has decreased significantly from 49% in 1950 [2] to 4% in 1987, mainly due to improvement in anesthetic and bloodbanking techniques. Perinatal mortality remains high at 31% [1]. Acute hypovolemic shock is the most typical finding. Other symptoms include abdominal pain and fetal distress. The most important diagnostic distinction to make is the one between intra-abdominal bleeding and placental abruption
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