Rafi Junaid, Mahindrakar Geetha, Mukhopadhyay Debjani
Ipswich Hospital NHS Trust, Heath Road, Ipswich IP4 5PD, UK.
Case Rep Obstet Gynecol. 2017;2017:3480287. doi: 10.1155/2017/3480287. Epub 2017 Apr 27.
Spontaneous haemoperitoneum in pregnancy (SHiP) due to endometriosis is a very rare condition and this is a case of a 41-year-old primigravida, who presented at 32 weeks with sudden onset of severe lower abdominal pain without any uterine activity. This was a dichorionic-diamniotic twin pregnancy, following in vitro fertilisation for subfertility secondary to severe endometriosis. On admission, pain score was eight, with ten being the maximum of the scale. The vital signs were stable. Abdominal palpation revealed generalised tenderness with no guarding or palpable contraction. There was no evidence of bleeding and the cervical os was closed on speculum examination. The cardiotocograph (CTG) was pathological and a plan was made to deliver the babies with emergency caesarean section. Intraoperatively, there was massive haemoperitoneum which was managed successfully with the involvement of multidisciplinary input from general surgeons and urologists with optimum maternal and fetal outcome.
子宫内膜异位症导致的妊娠期自发性腹腔内出血（SHiP）是一种非常罕见的病症，本文报告一例41岁初产妇，在孕32周时突然出现严重下腹痛，无任何子宫收缩活动。这是一例双绒毛膜双羊膜囊双胎妊娠，因严重子宫内膜异位症继发不孕而接受体外受精。入院时，疼痛评分为8分，满分10分。生命体征稳定。腹部触诊显示全腹压痛，无肌紧张或可触及的宫缩。无出血迹象，窥阴器检查宫颈口闭合。胎心监护（CTG）结果异常，计划行急诊剖宫产分娩胎儿。术中发现大量腹腔内出血，在普通外科医生和泌尿外科医生的多学科协作下成功处理，母婴结局良好。
