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Case Reports in Obstetrics and Gynecology
Volume 2017 (2017), Article ID 3480287, 3 pages
https://doi.org/10.1155/2017/3480287
Case Report

Endometriosis Nodule Causing Spontaneous Haemoperitoneum in Pregnancy: A Case Report and Literature Review

Ipswich Hospital NHS Trust, Heath Road, Ipswich IP4 5PD, UK

Correspondence should be addressed to Junaid Rafi

Received 21 February 2017; Revised 30 March 2017; Accepted 11 April 2017; Published 27 April 2017

Academic Editor: Julio Rosa-e-Silva

Copyright © 2017 Junaid Rafi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Spontaneous haemoperitoneum in pregnancy (SHiP) due to endometriosis is a very rare condition and this is a case of a 41-year-old primigravida, who presented at 32 weeks with sudden onset of severe lower abdominal pain without any uterine activity. This was a dichorionic-diamniotic twin pregnancy, following in vitro fertilisation for subfertility secondary to severe endometriosis. On admission, pain score was eight, with ten being the maximum of the scale. The vital signs were stable. Abdominal palpation revealed generalised tenderness with no guarding or palpable contraction. There was no evidence of bleeding and the cervical os was closed on speculum examination. The cardiotocograph (CTG) was pathological and a plan was made to deliver the babies with emergency caesarean section. Intraoperatively, there was massive haemoperitoneum which was managed successfully with the involvement of multidisciplinary input from general surgeons and urologists with optimum maternal and fetal outcome.