title: Spontaneous uterine artery rupture during pregnancy in a woman with sickle cell disease: a case report.
abstract: BACKGROUND
  Spontaneous rupture of uterine vessels during pregnancy is rare and usually involves uteroovarian veins. Presenting symptoms include acute-onset abdominal pain and maternal hypovolemic collapse due to hemoperitoneum. An atypical case of subacute uterine artery rupture at 27 weeks of gestation occurred in a woman with sickle cell disease.
  
  
  METHODS
  A 28-year-old, nulliparous woman with sickle cell disease was admitted at 27 weeks of gestation for sharp abdominal pain radiating to the right flank. The first diagnosis included acute renal colic and a sickling vasoocclusive crisis. One week after admission the patient experienced paroxysmal, diffuse abdominal pain associated with acute fetal distress requiring an emergency cesarean section. Laparotomy revealed an 800-mL hemoperitoneum. Active bleeding from a ruptured uterine artery was observed and successfully treated by selective suture.
  
  
  CONCLUSIONS
  Spontaneous rupture of the uterine artery during pregnancy may present as a 2-step process.
authors.affiliation: Service of Gynecology and Obstetrics and Reproductive Medicine, Hôpital Tenon, Paris, France. ofiori@freesurf.fr
authors.forename: Olivia
authors.initials: O
authors.lastname: Fiori
authors.forename: Hervé
authors.initials: H
authors.lastname: Prugnolles
authors.forename: Emile
authors.initials: E
authors.lastname: Darai
authors.forename: Serge
authors.initials: S
authors.lastname: Uzan
authors.forename: Nadia
authors.initials: N
authors.lastname: Berkane
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications*; D001158:Arteries / Q000473:pathology*; D005260:Female; D006465:Hemoperitoneum / Q000209:etiology; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000473:pathology*; D012422:Rupture, Spontaneous; D014599:Uterus / Q000098:blood supply*