Department of Obstetrics & Gynaecology, Royal Hospital, Muscat, Oman.
Department of Radiology, Royal Hospital, Muscat, Oman.
Sultan Qaboos Univ Med J. 2022 May;22(2):291-294. doi: 10.18295/squmj.5.2021.102. Epub 2022 May 26.
Intraperitoneal haemorrhage during pregnancy or postpartum without any history of trauma (spontaneous haemoperitoneum in pregnancy [SHiP]) is a rare condition, causing significant morbidity and mortality for the mother and the neonate. We report a 27-year-old female patient with SHiP at 31 weeks of gestation who was referred to a tertiary care hospital in Muscat, Oman, in 2019, with right iliac fossa pain, pallor and tachycardia. Radiological investigations revealed intraperitoneal bleeding and a right adnexal haematoma. She was managed conservatively with blood transfusion and supportive care. At 36 weeks of gestation, lower segment caesarean section was done and a live baby with good Apgar score was delivered. Pre-operatively, she was found to have a bicornuate uterus, placenta percreta at the junction of the horns and a right adnexal haematoma. This case highlights the significance of thorough evaluation of acute abdominal pain in pregnancy in avoiding unnecessary surgical intervention and iatrogenic prematurity.
妊娠或产后无创伤史的腹腔内出血(妊娠自发性血腹 [SHiP])较为罕见,但会导致母亲和新生儿出现严重的发病率和死亡率。我们报告了一位 27 岁的女性患者,她在妊娠 31 周时发生了 SHiP,并于 2019 年被转诊至阿曼马斯喀特的一家三级保健医院,她出现右髂窝疼痛、苍白和心动过速。影像学检查显示腹腔内出血和右侧附件血肿。她接受了输血和支持性治疗的保守治疗。在妊娠 36 周时,进行了下段剖宫产术,产下了一名阿普加评分良好的活婴。术前发现她有双角子宫,角部交界处胎盘植入和右侧附件血肿。该病例强调了在妊娠中对急性腹痛进行彻底评估的重要性,以避免不必要的手术干预和医源性早产。