Ob Gyn, University of Nebraska Medical Center, Omaha, Nebraska, USA
Ob Gyn, University of Nebraska Medical Center, Omaha, Nebraska, USA.
BMJ Case Rep. 2024 Jan 31;17(1):e258052. doi: 10.1136/bcr-2023-258052.
This is a case of a spontaneous haemoperitoneum occurring in the second trimester of pregnancy which was managed with interventional radiology to avoid laparotomy and its potential consequences. We aim to raise awareness of this condition in pregnancy because the perinatal mortality rate is as high as 36%. Spontaneous haemoperitoneum in pregnancy (SHiP) has frequently been associated with vascular rupture from pre-existing endometriosis. Most cases of SHiP have been managed with laparotomy. However, transcatheter embolisation can impart lifesaving alternatives to more invasive interventions when caring for pregnant patients. More judicious use of imaging procedures may also help improve diagnostic and therapeutic pathways with SHiP. We recommend that high-risk pregnancies are managed in level IV regional perinatal healthcare centres, when possible, where subspecialists and alternative measures of management exist.
这是一例发生在妊娠中期的自发性腹腔积血病例,通过介入放射学进行治疗,以避免开腹手术及其潜在的后果。我们旨在提高人们对妊娠期间这种情况的认识,因为围产期死亡率高达 36%。妊娠自发性腹腔积血(SHiP)常与先前存在的子宫内膜异位症引起的血管破裂有关。大多数 SHiP 病例已通过剖腹手术进行治疗。然而,在为孕妇提供护理时,经导管栓塞可以为更具侵袭性的干预措施提供救生替代方案。更明智地使用成像程序也可能有助于改善 SHiP 的诊断和治疗途径。我们建议尽可能在具备专科医生和其他管理措施的 IV 级区域围产期保健中心管理高危妊娠。