Spontaneous Hemoperitoneum Due to Ruptured Uterine Artery: A Rare Complication During Pregnancy

TL;DR

A rare case of a ruptured uterine artery causing internal bleeding during pregnancy is reported, highlighting the need for awareness of this dangerous condition.

Contribution

This case report adds to the medical literature by documenting a rare cause of hemoperitoneum during pregnancy.

Findings

A 29-year-old woman at 36 weeks gestation presented with acute abdomen due to hemoperitoneum.

Exploratory surgery revealed a bleeding left uterine artery and extensive blood clots in the upper abdomen.

The case underscores the importance of considering uterine artery rupture in differential diagnoses of hemoperitoneum during pregnancy.

Abstract

Spontaneous rupture of the uterine artery is a rare and life-threatening cause of hemoperitoneum in pregnancy, associated with high maternal and perinatal morbidity and mortality. We present a case of a 29-year-old woman, in the 36th week of gestation, with acute abdomen due to hemoperitoneum. Ultrasound revealed free fluid in the abdominal cavity, with no signs of fetal distress, and the patient was mildly hypotensive. Exploratory laparotomy and cesarean section were performed, and extensive blood clots on the upper abdominal quadrants were discovered, as well as a bleeding left uterine artery. We expect that this case raises awareness of the ruptured uterine artery as a possible etiology of hemoperitoneum during pregnancy.

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