Successful laparoscopic management of a spontaneous hemoperitoneum, at 15 weeks of pregnancy. A case report and review of literature.

J Minim Invasive Gynecol. 2009 Nov-Dec;16(6):792-4. Successful laparoscopic management of spontaneous hemoperitoneum at 15 weeks of pregnancy: case report and review of literature. Pezzuto A, Pomini P, Steinkasserer M, Nardelli GB, Minelli L. SourceDepartment of Obstetrics, Gynaecology, and Neonatology, Center for Reporductive Medicine, University of Parma, Italy. antoniocosimopezzuto@virgilio.it Abstract We present a case report of laparoscopic management of a spontaneous hemoperitoneum in the second trimester of pregnancy. The patient was a 40-year-old woman at 15 weeks of gestation. At laparoscopic surgery, the hemoperitoneum was evacuated, and the right-sided uterine vessels were closed with diathermocoagulation. Every pregnant woman with severe abdominal pain, vomiting, and imminent hypovolemic shock should be carefully evaluated. After ruling out the most prevalent causes of hemoperitoneum, idiopathic spontaneous hemoperitoneum should be considered. Rapid diagnosis and aggressive fluid replacement together with prompt surgical intervention may be the only chance for a favorable outcome for both mother and child in the presence of such a rare complication. Moreover, in early stages of pregnancy, the laparoscopic approach should be considered but only in the hands of experienced laparoscopic surgeons