Incidental hemoperitoneum from ruptured superficial uterine veins in twin pregnancy
Hemoperitoneum in pregnancy is rare (especially from ruptured uterine vessels) and potentially life‑threatening for both the mother and the fetus. It commonly occurs in the third trimester and in labor. The clinical presentations vary from severe abdominal pain and shock to nonspecific symptoms. Prompt and correct diagnosis, adequate fluid and blood resuscitation, and surgical intervention are essential to prevent maternal and perinatal morbidity and mortality. A 26‑year‑old primigravida with twin gestation at 34 weeks presented in labor with footling breech presentation, cervical dilatation of 5 cm, and fetal tachycardia. She had an emergent cesarean section, and incidental hemoperitoneum of 1.1 L was encountered as well as bleeding anterior and posterior uterine serosa veins. The neonates were safely delivered, and the bleeding veins were ligated with vicryl suture. The mother and twins were discharged home afterward in stable condition.
Keywords: Hemoperitoneum; pregnancy; superficial; twin; uterus; veins
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