BACKGROUND:

Spontaneous hemoperitoneum is a rare complication in pregnancy (1 in 100.000 pregnancies) with a great impact on maternal and fetal morbidity and mortality.

CLINICAL CASE:

A 44-year-old woman, 21+6 weeks pregnant, with a diagnosis of endometriosis, who went to the Emergency Department due to abdominal pain. After verifying fetal viability, an urgent abdominal ultrasound was requested in which free fluid was visualized at the level of Morrison’s fossa, perisplenic and perihepatic. During her stay in the Emergency Department, she developed acute anemia accompanied by hemodynamic instability, for which an urgent exploratory laparotomy was performed. Among the operative findings, the presence of hemoperitoneum of 1,5 liters and bleeding at the level of the right adnexa and parametrium stood out. In ultrasound control 12 hours after the intervention, the absence of a fetal heartbeat was verified producing the spontaneuous expulsion of the fetus at 72 hours. Subsequently, the patient’s evolution was favorable, and she was discharged 10 days after the intervention.

CONCLUSION:

Although during pregnancy there is no way to anticipate the occurrence of complications from pre-existing endometriosis. It is important the severe abdominal pain occurs, to suspect rare but life-threatening events.

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