Management of Hemoperitoneum Secondary to Bleeding Disorders in Low-Middle-Income Countries

Bleeding disorders (BD) in women are rarely addressed in resource-limited settings. Ovulation can lead to life-threatening haemorrhage in women with BD. The management of bleeding complications in these persons can range from conservative management to surgery. This case series describes women with different BD who developed hemoperitoneum, a potentially fatal complication.

We reviewed the cases of 5 women in the reproductive age group with BD who developed hemoperitoneum. Patient Demographics, clinical presentation, diagnostic workup, management strategies, and outcomes for each case, highlighting the role of blood product support, antifibrinolytics, and surgical intervention, are analyzed and discussed.

Our study revealed that 4 out of 5 women responded well to conservative management, thereby avoiding the need for surgical intervention. The woman with GT who expired had developed a massive hemoperitoneum due to a delayed bleed from the surgical site.

In the context of absent guidelines for the management of hemoperitoneum in BD, this case series contributes by providing insights into the management. Our case series reveals that hemoperitoneum in women with BD responds to conservative management, and surgical interventions should be approached with caution, particularly in persons with Glanzmann's thrombasthenia, due to the risk of uncontrollable bleeding.