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Case Report
 
Hemoperitoneum due to spontaneous uterine rupture of varicose veins in a twin pregnancy at term: A clinical case study presentation
Mariétou Thiam1, Mouhamadou Mansour Niang2, Papa Abdoulaye BA3, Lamine Gueye4, Marie Edouard Faye Diémé5, Mamadou Lamine Cissé6
1MD, Assistant Professor, Department of Obstetrics and Gynecology of the Thiès Regional Hospital, Faculty of Medicine, Thiès University, Thiès, Senegal.
2MD, Assistant Professor, Department of Obstetrics and Gynecology, Cheikh Anta Diop University, Dakar, Senegal.
3MD, Assistant Professor Department of General Surgery, Faculty of Medicine, Thiès University, Thiès, Senegal.
4MD, Department of Obstetrics and Gynecology, regional hospital Thiès, Senegal.
5MD, Professor, Department of Obstetrics and Gynecology, Cheikh Anta Diop University, Dakar, Senegal.
6MD, Professor, Department of Obstetrics and Gynecology of the Thiès Regional Hospital, Senegal, Thiès University, Thiès, Senegal.

Article ID: 100017Z08MT2016
doi:10.5348/Z08-2016-17-CR-10

Address correspondence to:
Mariétou Thiam
MD, Assistant professor, Department of Obstetrics and Gynecology of the Thiès Regional Hospital
Faculty of Medicine
Thiès University, Thiès
Senegal. BP 34 A Thiès

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How to cite this article:
Thiam M, Niang MM, Papa Abdoulaye BA, Gueye L, Diémé MEF, Cissé ML. Hemoperitoneum due to spontaneous uterine rupture of varicose veins in a twin pregnancy at term: A clinical case study presentation. J Case Rep Images Gynecol Obstet 2016;2:44–48.


Abstract
Introduction: Spontaneous rupture of uterine vessels during pregnancy is an exceptional situation.
Case Report: We report a case of massive hemoperitoneum due to spontaneous rupture of uterine varicose veins, occurring in a patient with twin pregnancy at 38 weeks gestation. The patient presented abdominal pain associated with a sudden drop in blood pressure and severe decompensated anemia. Ultrasound scan revealed in-utero fetal demise of the twins with a peritoneal effusion. An emergency laparotomy followed by a cesarean section confirmed the diagnosis, etiology and management with a favorable maternal outcome.
Conclusion: Spontaneous rupture of uterine varicose veins during pregnancy is a rare condition. Clinicians should be aware with this rare condition as delayed diagnosis can be fatal for mother and fetus. The definitive diagnosis of this condition is often made intraoperatively. However, the clinical presentation with ultrasound scanning is very important in planning the management of this condition.

Keywords: Fetal demise, Hemoperitoneum, Rupture of uterine vessels, Twin pregnancy


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Author Contributions
Mariétou Thiam – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Mouhamadou Mansour Niang – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Papa Abdoulaye BA – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Lamine Gueye – Acquisition of data, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Marie Edouard Faye Diémé – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Mamadou Lamine Cissé – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
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Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Mariétou Thiam et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.