Spontaneous Rupture of Uterine Vein in Twin Pregnancy

Objective. Aim of our study is to present a case of a twin pregnancy following invitro fertilization cycle complicated with hemoperitoneum at third trimester. Case. A 26-year-old nulliparous pregnant woman at 32 weeks of gestation with twin pregnancy following invitro fertilization cycle complained of abdominal pain. After 48 hours of admission, laparotomy was performed with indications of aggravated abdominal pain and decreased hemoglobin levels. Utero-ovarian vein branch rupture was detected on the right posterior side of uterus and bleeding was stopped by suturing the vein. Etiopathogenesis of the present case still remains unclear. Conclusion. Spontaneous rupture of the uterine vessels during pregnancy is a rare complication and may lead to maternal and fetal morbidity and mortality. Diagnosis and treatment are based on the clinical symptoms of acute abdominal pain and laboratory tests of hypovolemic shock signs.

[1]  N. Kanayama,et al.  A case of spontaneous rupture of a uterine superficial varicose vein in midgestation , 2011, The journal of obstetrics and gynaecology research.

[2]  L. S. Castro,et al.  Rotura espontánea de variz uterina durante la gestación. Descripción de dos casos y revisión bibliográfica , 2010 .

[3]  M. Andrés-Orós,et al.  [Spontaneous uterine venous rupture during pregnancy. Description of two cases and bibliographical review]. , 2010, Ginecologia y obstetricia de Mexico.

[4]  J. Brosens,et al.  Endometriosis is a risk factor for spontaneous hemoperitoneum during pregnancy. , 2009, Fertility and Sterility.

[5]  L. Arsenijević,et al.  [Spontaneous intra-abdominal bleeding in twin pregnancy--case report]. , 2008, Srpski arhiv za celokupno lekarstvo.

[6]  M. Ibarrola,et al.  Spontaneous hemoperitoneum in a twin pregnancy complicated by endometriosis , 2008, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[7]  C. Calhaz-Jorge,et al.  Endometriosis is a possible risk factor for spontaneous hemoperitoneum in the third trimester of pregnancy. , 2008, Fertility and sterility.

[8]  D. Soriano,et al.  Severe intraabdominal bleeding caused by endometriotic lesions during the third trimester of pregnancy. , 2007, American journal of obstetrics and gynecology.

[9]  K. Seow,et al.  Spontaneous hemoperitoneum in pregnancy from a ruptured superficial uterine vessel. , 2007, Taiwanese journal of obstetrics & gynecology.

[10]  W. Prendiville,et al.  Spontaneous uterine artery rupture: A rare cause of abdominal pain in pregnancy , 2005, Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology.

[11]  Uzma Aziz,et al.  Spontaneous Rupture of the Uterine Vessels in Pregnancy , 2004, Obstetrics and gynecology.

[12]  C. Gérard,et al.  Rupture spontanée des vaisseaux utéro-ovariens dans le post-partum: À propos d'un cas et revue de la littérature , 2003 .

[13]  L. Baeyens,et al.  [Spontaneous rupture of utero-ovarian vessels in postpartal period: a case report and review of the literature]. , 2003, Journal de gynecologie, obstetrique et biologie de la reproduction.

[14]  B. Loevinsohn Value of the obstetric partogram , 1992, The Lancet.

[15]  Takami Inoue,et al.  Endometriosis and spontaneous rupture of utero-ovarian vessels during pregnancy , 1992, The Lancet.

[16]  K. Ginsburg,et al.  Spontaneous utero-ovarian vessel rupture during pregnancy: three case reports and a review of the literature. , 1987, Obstetrics and gynecology.

[17]  A. J. Jurishica,et al.  Bleeding from Utero‐ovarian Vessels , 1955, Obstetrics and gynecology.

[18]  C. Hodgkinson,et al.  Hemorrhage from Ruptured Uteroovarian Veins During Pregnancy , 1950 .

[19]  C. Hodgkinson,et al.  Hemorrhage from ruptured utero-ovarian veins during pregnancy; report of 3 cases and review of the literature. , 1950, American journal of obstetrics and gynecology.