title: Haemoperitoneum associated with ovulation in women with bleeding disorders: the case for conservative management and the role of the contraceptive pill.
abstract: Haemoperitoneum secondary to ruptured corpus luteum is a rare complication for women on anticoagulants and with certain congenital bleeding disorders. A surgical approach is often taken, leading to oophorectomy in many cases. We describe three patients presenting with haemoperitoneum in association with factor VII deficiency, factor X deficiency and sitosterolaemia. In two of the patients, recurrent episodes occurred prior to introduction of the oral contraceptive pill. Conservative management with blood product and factor concentrate support was successful in avoiding surgery in three of the five episodes of bleeding. These cases demonstrate that preservation of ovarian function is possible with a conservative approach and recurrent episodes may be prevented by suppression of ovulation.
authors.affiliation: Department of Haematology, Royal Hallamshire Hospital, Sheffield, UK.
authors.forename: J H
authors.initials: JH
authors.lastname: Payne
authors.forename: R M
authors.initials: RM
authors.lastname: Maclean
authors.forename: K K
authors.initials: KK
authors.lastname: Hampton
authors.forename: A J
authors.initials: AJ
authors.lastname: Baxter
authors.forename: M
authors.initials: M
authors.lastname: Makris
mesh_terms: D000328:Adult; D001778:Blood Coagulation Disorders / Q000150:complications* / Q000188:drug therapy; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use*; D003338:Corpus Luteum / Q000293:injuries; D005168:Factor VII Deficiency / Q000150:complications; D005171:Factor X Deficiency / Q000150:complications; D005260:Female; D006465:Hemoperitoneum / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D010060:Ovulation / Q000187:drug effects*; D012422:Rupture, Spontaneous; D012855:Sitosterols / Q000097:blood
chemical_list: D003278:Contraceptives, Oral, Hormonal; D012855:Sitosterols