Hemoperitoneum in third trimester of pregnancy: Unusual cause-spontaneous rupture of uterine varices

Abstract

Spontaneous uterine varices rupture is a very rare condition (1/10,000 pregnancies), leading to significant maternal and fetal morbidity and mortality. Though the exact etiology is still unknown, it seems to be associated with an increased in venous pressure. The rupture especially occurs in third trimester. We encounter a case of 31 years old primigravida with pain in abdomen since 1 day not relieved by medication. Abdominal ultrasound revealed hemoperitoneum. Emergency exploratory laparotomy revealed 1.5 litres of hemoperitoneum and confirmed the diagnosis of ‘spontaneous rupture of uterine varices’. The clinical presentation of spontaneous rupture of uterine varices is not specific and clinical examination and ultrasonographic scanning may be insufficient for diagnosis. This rare condition has to be taken into account to the differential diagnosis in a pregnant woman with severe abdominal pain.