Case report: intra-partum utero-ovarian vessels rupture

We report the rare case of a 39-year-old woman who had an intra-partum hemoperitoneum that resulted from spontaneous rupture of the utero-ovarian vessels. During the expulsive efforts, the patient repeatedly complained of bilateral shoulder discomfort and some respiratory difficulty. Because she had hemodynamic instability and an abdomino-pelvic ultrasound revealed the presence of extensive free fluid within the peritoneal cavity, the patient underwent an exploratory laparotomy. The surgery revealed an extensive laceration of the anterior leaf of the left broad ligament and vesico-uterine peritoneum, and active bleeding from the utero-ovarian vessels with no evidence of uterine rupture.

Intra-partum haemoperitoneum resulting from rupture of the utero-ovarian vessels is a rare obstetrical emergency that needs rapid resuscitation with fluid and/or blood replacement and prompt surgical intervention.