title: Unexpected obstetric haemorrhage. Krukenberg tumour.
abstract: Obstetric haemorrhage can endanger the lives of mother and foetus. It often occurs unexpectedly without clear predictors. A high degree of suspicion helps to avoid delaying resuscitation measures. We present the case of a ruptured ovarian metastasis that occurred during labour. It caused a massive bleed forcing a caesarean section due to non-reassuring foetal status. This was an unprecedented and undescribed onset of Krukenberg tumour formation. Malignant tumours in pregnancy are rare and difficult to diagnose due to their clinical manifestations which often overlap with those of pregnancy itself (dyspepsia, nausea and bloating). Despite the available therapeutic measures, a delay in diagnosis is a determining factor for long-term prognosis. We review the causes of obstetric bleeding, and underline how rare Krukenberg tumours concomitant to pregnancy are.
authors.affiliation: Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario de Guadalajara, Guadalajara, España. Electronic address: jorge.montorog@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Montoro García
authors.affiliation: Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario de Guadalajara, Guadalajara, España.
authors.forename: M
authors.initials: M
authors.lastname: Cabellos Olivares
authors.affiliation: Servicio de Ginecología y Obstetricia, Hospital Universitario de Guadalajara, Guadalajara, España.
authors.forename: A
authors.initials: A
authors.lastname: Cabana Navia
authors.affiliation: Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario de Guadalajara, Guadalajara, España.
authors.forename: J
authors.initials: J
authors.lastname: López Saña
authors.affiliation: Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario de Guadalajara, Guadalajara, España.
authors.forename: J R
authors.initials: JR
authors.lastname: Rodríguez Fraile
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002585:Cesarean Section; D003131:Combined Modality Therapy; D057210:Delayed Diagnosis; D004630:Emergencies; D005260:Female; D005316:Fetal Distress / Q000209:etiology; D006465:Hemoperitoneum / Q000209:etiology*; D006801:Humans; D007231:Infant, Newborn; D007725:Krukenberg Tumor / Q000150:complications / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D007751:Labor, Induced; D007744:Obstetric Labor Complications / Q000209:etiology*; D010051:Ovarian Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D011225:Pre-Eclampsia / Q000188:drug therapy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis; D018714:Radiotherapy, Adjuvant; D012422:Rupture, Spontaneous; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000601:surgery
chemical_list: D000959:Antihypertensive Agents
keywords: Hemorragia obstétrica; Hemorragia posparto inesperada; Krukenberg tumour; Obstetric haemorrhage; Postpartum haemorrhage; Tumor de Krukenberg