title: Successful laparoscopic management of spontaneous hemoperitoneum at 15 weeks of pregnancy: case report and review of literature.
abstract: We present a case report of laparoscopic management of a spontaneous hemoperitoneum in the second trimester of pregnancy. The patient was a 40-year-old woman at 15 weeks of gestation. At laparoscopic surgery, the hemoperitoneum was evacuated, and the right-sided uterine vessels were closed with diathermocoagulation. Every pregnant woman with severe abdominal pain, vomiting, and imminent hypovolemic shock should be carefully evaluated. After ruling out the most prevalent causes of hemoperitoneum, idiopathic spontaneous hemoperitoneum should be considered. Rapid diagnosis and aggressive fluid replacement together with prompt surgical intervention may be the only chance for a favorable outcome for both mother and child in the presence of such a rare complication. Moreover, in early stages of pregnancy, the laparoscopic approach should be considered but only in the hands of experienced laparoscopic surgeons.
authors.affiliation: Department of Obstetrics, Gynaecology, and Neonatology, Center for Reporductive Medicine, University of Parma, Italy. antoniocosimopezzuto@virgilio.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Pezzuto
authors.forename: Paola
authors.initials: P
authors.lastname: Pomini
authors.forename: Martin
authors.initials: M
authors.lastname: Steinkasserer
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Nardelli
authors.forename: Luca
authors.initials: L
authors.lastname: Minelli
mesh_terms: D000328:Adult; D004564:Electrocoagulation; D005260:Female; D006465:Hemoperitoneum / Q000150:complications / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery*; D011262:Pregnancy Trimester, Second