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Rupture of perivascular epithelioid cell neoplasm at 34 weeks’ gestation: A nonendometriosis case of spontaneous hemoperitoneum in pregnancy
Author(s) -
Nitahara Kenta,
Sasaki Megumi,
Ichikawa Saori,
Tsuji Keita,
Yoshida Yuji
Publication year - 2019
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13870
Subject(s) - medicine , hemoperitoneum , pregnancy , uterus , gestation , context (archaeology) , ovary , uterine rupture , endometriosis , vaginal bleeding , surgery , gynecology , radiology , obstetrics , paleontology , genetics , biology
Spontaneous hemoperitoneum in pregnancy (SHiP) has mainly been discussed in the context of endometriosis. With hormonal changes and enlargement of the uterus during pregnancy, tumors can also increase the chance of rupture and consequent SHiP. We report a case of a 30‐year‐old primiparous woman presented with sudden‐onset intraabdominal hemorrhage at 34 weeks’ gestation. The source of bleeding was rupture of a perivascular epithelioid cell neoplasm on the left round ligament of the uterus. The pregnancy ended with an uncomplicated, full‐term, vaginal delivery. We performed an additional post‐partum surgery to resect the left round ligament and transposition of the right ovary. In cases of SHiP, the possibility of a nonendometriosis origin should be considered. Preoperative imaging and histologic examinations of bleeding lesions are crucial for managing SHiP.