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Updated: Feb 11, 2026
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Idiopathic spontaneous hemoperitoneum during pregnancy
Summary
Spontaneous hemoperitoneum, a rare pregnancy complication, involves internal bleeding without clear cause. This case series highlights two instances in the third trimester, requiring emergency C-sections due to fetal distress and significant internal blood.
Area of Science:
- Obstetrics and Gynecology
- Surgical Case Reports
Background:
- Spontaneous hemoperitoneum (SH) is defined as intra-abdominal bleeding without trauma or iatrogenic cause.
- SH during pregnancy is exceptionally rare and poses a significant risk to both mother and fetus.
- Idiopathic SH occurs when the bleeding source remains unidentified even after surgical exploration.
Observation:
- Two pregnant patients presented with sudden, severe abdominal pain in the third trimester.
- Both cases were diagnosed with spontaneous hemoperitoneum, characterized by substantial intra-abdominal blood accumulation.
- Emergency Cesarean sections were performed due to emergent fetal distress in both patients.
Findings:
- Surgical exploration revealed large quantities of hemoperitoneum in both cases.
- Despite thorough investigation during laparotomy, the specific source of bleeding could not be identified in either patient, classifying these as idiopathic SH.
- The management involved immediate surgical delivery of the infants.
Implications:
- This condition underscores the importance of prompt diagnosis and surgical intervention in cases of sudden abdominal pain during pregnancy.
- The idiopathic nature of SH in these cases highlights diagnostic challenges and the need for continued research into potential underlying causes.
- Early recognition and Cesarean delivery are critical for improving fetal outcomes in life-threatening SH during pregnancy.
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