title: Endometriosis-Related Hemoperitoneum in Pregnancy: A Diagnosis to Keep in Mind.
abstract: BACKGROUND
  Endometriosis is an important gynecologic clinical entity, pathologically defined by the ectopic presence of endometrium and frequently associated with pelvic pain, that affects approximately 10% of females of reproductive age. A rare but severe complication of endometriosis during pregnancy is spontaneous hemoperitoneum in pregnancy (SHiP), severe intraabdominal bleeding that can be life threatening.
  
  
  METHODS
  We present the case of a patient with SHiP at 29 weeks of pregnancy. A supraumbilical midline laparotomy was performed, and pelvic exploration revealed a lacerated and bleeding right ovary. Right annessiectomy was performed, and a cesarean section was performed because hemostasis was not achievable. A healthy baby was born, and hemostasis was finally achieved.
  
  
  CONCLUSIONS
  We believe that in gravid females with a history of endometriosis, severe abdominal pain, and a reduction of hemoglobin, physicians should always suspect SHiP. Because SHiP is a life-threatening condition for both the mother and the baby, a prompt diagnosis must lead to prompt treatment.
authors.affiliation: Department of Biomedical, Experimental, and Clinical Sciences-Division of Obstetrics and Gynecology, University of Florence, Florence, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Cozzolino
authors.affiliation: Department of Biomedical, Experimental, and Clinical Sciences-Division of Obstetrics and Gynecology, University of Florence, Florence, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Corioni
authors.affiliation: Department of Biomedical, Experimental, and Clinical Sciences-Division of Obstetrics and Gynecology, University of Florence, Florence, Italy.
authors.forename: Luana
authors.initials: L
authors.lastname: Maggio
authors.affiliation: Department of Biomedical, Experimental, and Clinical Sciences-Division of Obstetrics and Gynecology, University of Florence, Florence, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Sorbi
authors.affiliation: Department of Biomedical, Experimental, and Clinical Sciences-Division of Obstetrics and Gynecology, University of Florence, Florence, Italy.
authors.forename: Secondo
authors.initials: S
authors.lastname: Guaschino
authors.affiliation: Department of Biomedical, Experimental, and Clinical Sciences-Division of Obstetrics and Gynecology, University of Florence, Florence, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Fambrini
keywords: Cesarean section; endometriosis; hemoperitoneum; neonatology; pregnancy; premature birth