Endometriosis is a possible risk factor for spontaneous hemoperitoneum in the third trimester of pregnancy

Idiopathic spontaneous haemoperitoneum in pregnancy

“…5 Maternal mortality associated with SHiP dropped dramatically throughout the years to approximately 4%. 3,[6][7][8] Foetal mortality on the other hand remains high involving more than 1/3 rd of all cases with most deaths attributable to maternal shock. 3,[6][7][8] The patient was fortunate to have survived such an ordeal but unfortunately the baby died in utero due to severe asphyxia following massive blood loss.…”

“…9 Some cases were also reported during intrapartum and in the early postpartum period. [6][7][8]10 .…”

Spontaneous Hemoperitoneum in the Immediate Post-Partum Caused by Endometriosis and Labour

“…An alternative explanation supposed by Brosens et al [2] may be the involution of decidualizing ectopic endometrium during pregnancy secondary to the fall of progesterone during the post-partum period [12,15,16]. Passos et al, as Cole et al [6,7] explained that the presence of surgical scared tissu related to previous laparoscopic surgeries may have further weakened vessel walls or provided points of fixation that could have been torn by the normal contractile process of the uterus. In the three cases, described by Zhang et al [17] patients had had previous surgical endometriosis care.…”

“…It is defined as an unprovoked intraperitoneal bleeding that may be idiopathic or related to many causes such as uterine rupture, placental abruption, spontaneous ruptures of uterine varicosities, placenta percreta, liver or splenic rupture in preeclampsia, trauma, ectopic pregnancy and other rare causes such as a spontaneous rupture of a splenic artery aneurysm, or a ruptured appendix. The most common cause of SH is spontaneous utero-ovarian vessel rupture in pregnancy [1][2][3][4][5][6][7][8][9][10][11][12]. SH in pregnancy occurred before labour for 61%, intrapartum for 18% and puerperal for 21%.…”

Bowel Endometriosis with Hemoperitoneum Complicating Pregnancy

“…The ovaries are the most common sites of involvement; however, endometriosis can be located in various anatomic sites, including uterosacral ligament, bladder, vagina, recto-vaginal septum (2), rectum/ sigmoid (3), appendix (4), ureters (5) and lymph nodes (6). Endometriosis is a major risk factor for spontaneous hemoperitoneum in pregnancy (SHiP) (6)(7)(8)(9)(10)(11) and fetal mortality. Here we report the case of a SHiP originating from uterine artery erosion caused by bowel endometriosis in a patient with no reported history of endometriosis.…”