Spontaneous Bilateral Broad Ligament Rupture Associated with a Connective Tissue Disorder

Abstract

Background: Hemoperitoneum secondary to spontaneous rupture of uterine vessels in the broad ligament during pregnancy usually results from trauma or varicose vein dilatation, leading to uterine vessel rupture.Case: A 33-year-old primigravida presented to the hospital for abdominal pain. Fetal distress led to an urgent caesarean. Abdominal exploration revealed hemoperitoneum secondary to bilateral lesion of the broad ligament and abnormal hysterotomia extension. The patient was referred for genetic evaluation of connective tissue disease. A fibrillin-1 (FBN-1) mutation was discovered; a mutation associated with Marfan syndrome. Conclusion:Although this patient had no other signs suggesting Marfan syndrome, the FBN-1 mutation may explain the bilateral broad ligament rupture without trauma. We recommend screening for connective tissue disease in patients with this complication.