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Abdominal apoplexy during pregnancy
Jasmeet Kumari1, Rosemary Harkin2
1Obstetrics and Gynaecology, Our Lady of Lourdes, Drogheda, Ireland Jasmeet2k58@yahoo.com.
BMJ Case Reports
|October 31, 2020
Summary
Idiopathic spontaneous intraperitoneal haemorrhage (ISIH) is a rare obstetric emergency. Prompt diagnosis and management are crucial for saving both mother and baby.
Area of Science:
- Obstetrics and Gynecology
- Emergency Medicine
- Surgical Case Reports
Background:
- Idiopathic spontaneous intraperitoneal haemorrhage (ISIH), also known as 'abdominal apoplexy', is a rare but potentially life-threatening obstetric emergency.
- It presents a diagnostic challenge due to its varied clinical manifestations and can lead to significant maternal and fetal morbidity and mortality.
Observation:
- A case of ISIH is presented in a 31-year-old patient at 37 weeks gestation experiencing sudden, severe left iliac fossa pain and uterine contractions.
- Clinical examination revealed early labor with a footling breech presentation.
Findings:
- An urgent cesarean section was performed, revealing intraperitoneal bleeding of unknown origin.
- The baby was safely delivered, and both mother and child were discharged on day 5 post-procedure.
Implications:
- This case underscores the importance of a high index of suspicion for diagnosing ISIH in pregnant patients presenting with acute abdominal pain.
- Prompt and decisive management, including surgical intervention, is critical for ensuring favorable outcomes for both mother and neonate in cases of ISIH.
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