Spontaan hemoperitoneum tijdens de zwangerschap: een zeldzame vorm van acute abdominale pijn tijdens de zwangerschap

Abstract

A spontaneous Hemoperitoneum during Pregnancy: a rare complication during pregnancy Background. Acute abdominal pain during pregnancy is a common cause of referral to the emergency department. Making the correct diagnosis is challenging, because symptoms in pregnant women can be non-specific or referred as a normal symptom caused by uterine growth. Case report series. Three cases are discussed. All of them are primigravida (39w5d, 36w2d and 23w6d). They attend at the emergency department because of acute abdominal pain, without vaginal blood loss, in absence of clear contractions and with good fetal conditions. The diagnosis is established by clinical assessment, blood results and medical imaging. The most favorable imaging for the diagnosis of free fluid is the execution of an abdominal ultrasound. In absence of fetal distress or signs of hypovolemic shock, watchful waiting could be applied. If the decision is made for surgical intervention, it consists of establishing hemostasis by laparoscopy or laparotomy. Maternal mortality is low, in contrast with a high perinatal morbidity and mortality. Conclusion: SHIP is a rare complication during pregnancy with a high perinatal morbidity and mortality. In half of the cases an association with endometriosis can be found. Recognition of SHIP is crucial to improve pregnancy outcomes.