Hemoperitoneum in peripartum: A case-series

Article type: Case Report

Authors: Lemaire, A.^{a; *} | Bonnin, M.^a | Storme, B.^a | Fournet-Fayard, A.^a | Rosano, G.^a | Vernis, L.^a | Cayot, S.^b | Accocebery, M.^c | Dechelotte, P.^d | Boyer, L.^e | Gallot, D.^c | Futier, E.^a | Constantin, J.M.^b | Bazin, J.E.^a

Affiliations: [a] Anesthésistes Réanimateurs, Pôle MPO, Gynécologie Obstétrique et Reproduction Humaine, Hôpital Estaing, CHU Clermont-Ferrand, 1 Place Lucie Aubrac, 63000 Clermont-Ferrand, France | [b] Anesthésistes Réanimateurs, Pôle MPO, Réanimation Adultes, Hôpital Estaing, CHU Clermont-Ferrand, 1 Place Lucie Aubrac, 63000 Clermont-Ferrand, France | [c] Gynécologues Obstétriciens, Pôle Gynécologie Obstétrique et Reproduction Humaine, Hôpital Estaing, CHU Clermont-Ferrand, 1 Place Lucie Aubrac, 63000 Clermont-Ferrand, France | [d] Anatomopathologiste, Anatomie et Cytologie Pathologiques, Hôpital Estaing, CHU Clermont-Ferrand, 1 Place Lucie Aubrac, 63000 Clermont-Ferrand, France | [e] Radiologue, Imagerie Médicale et Radiologie Interventionnelle, Hôpital Gabriel Montpied, Place Henri Dunant, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France

Correspondence: [*] Address for correspondence: Alexandre Lemaire, MD, Anesthésistes Réanimateurs, Pôle MPO, Gynécologie Obstétrique et Reproduction Humaine, Hôpital Estaing, CHU Clermont-Ferrand, 1 Place Lucie Aubrac, 63000 Clermont-Ferrand, France. Tel.: +33631386987; E-mail: a_lemaire@chu-clermontferrand.fr.

Abstract: Hemorrhages are the first cause of perinatal deaths in French women. Thirteen percent of these deaths are not linked to obstetrical problems but rather to hemoperitoneum. These incidents are under-diagnosed and as a result, treatment is delayed and fetal and maternal mortality increases. We report three cases of patients, all White female in their last trimester of a non-problematic pregnancy presenting with hemoperitoneum and resulting in different outcomes. The analysis of published materials and of our cases leads us to infer that a diagnosis of hemoperitoneum must be considered in pregnant women when abdominal pain, symptoms of shock and a decrease in hemoglobin are associated. An immediate response and intensive care followed by hemostatic surgery give these patients the best chance to survive.

Keywords: Hemoperitoneum, pregnancy, aneurysm, spleen

DOI: 10.3233/NPM-171659

Journal: Journal of Neonatal-Perinatal Medicine, vol. 10, no. 4, pp. 451-454, 2017