Placental Abruption Leading to Hemosalpinx: A Rare Presentation

Abstract

A spontaneous hemoperitoneum during the second or third trimester is a rare event but potentially life threatening to both mother and fetus. At the same time, both its certain diagnosis and the identification of its cause are difficult. Hemoperitoneum in pregnant women appears in its most standard form as acute abdominal pain, sometimes accompanied by maternal shock, depending on its volume. Diagnosis during pregnancy is difficult because of its low prevalence and its nonspecific clinical findings. Spontaneous hemoperitoneum may mimic placental abruption having similar clinical presentation like acute abdominal pain, shock and fetal distress or death. Diagnosis of the cause becomes difficult because both obstetric and non-obstetric causes must be considered and because computed tomography and magnetic resonance imaging are used less often during pregnancy. The speed of diagnosis and timely surgical intervention with appropriate volume replacement is a key element in maternal and fetal outcome. We present a case of spontaneous hemoperitoneum in third trimester of pregnancy and its objective is to share our experience in managing this emergency condition though rare in pregnancy and all the diagnostic dilemmas we had during this case management.