Rupture of a Uterine or Ovarian Artery During Pregnancy with Abdominal Pain and Hemoperitoneum

 

Patient selection: pregnant or recently pregnant female

 

Clinical features:

(1) sudden onset of abdominal pain

(2) hemoperitoneum

(3) hypotension

(4) falling hemoglobin levels

(5) variable fetal distress (if pregnant)

(6) absence of trauma or surgery (spontaneous)

 

Some patients may have evidence of:

(1) an aneurysm in the affected artery preceding the event.

(2) sickle cell disease

(3) hereditary defect of connective tissue (Ehlers-Danlos, Marfan, etc)

 

Differential diagnosis:

(1) rupture of the splenic artery