Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2020; 8(14): 3074-3081
Published online Jul 26, 2020. doi: 10.12998/wjcc.v8.i14.3074
Intra-abdominal hemorrhage during pregnancy: Four case reports
Lei Yang, Na Liu, Yan Long
Lei Yang, Na Liu, Yan Long, Department of Obstetrics and Gynecology, Beijing Friendship Hospital, Capital University of Medical Sciences, Beijing 100050, China
Author contributions: Yang L conducted the operation, collection, analysis and interpretation of data and drafted this manuscript; Liu N conducted the operation and collected data; Long Y guided the operation and revised the manuscript; All the authors have read and approved the manuscript and believe that the manuscript represents honest work.
Informed consent statement: Written informed consent was obtained from all patients.
Conflict-of-interest statement: This study was approved by the Ethics Committee of Beijing Friendship Hospital.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yan Long, MD, Doctor, Department of Obstetrics and Gynecology, Beijing Friendship Hospital, Capital University of Medical Sciences, No. 95, Yongan Road, Xicheng District, Beijing 100050, China. betty_ll@163.com
Received: January 15, 2020
Peer-review started: January 15, 2020
First decision: April 21, 2020
Revised: June 23, 2020
Accepted: June 30, 2020
Article in press: June 30, 2020
Published online: July 26, 2020
Processing time: 187 Days and 5.3 Hours
Abstract
BACKGROUND

Intra-abdominal hemorrhage during pregnancy is a rare and dangerous complication of pregnancy. In this article, we report 4 cases of intra-abdominal hemorrhage during pregnancy, including the spontaneous rupture of uterine veins, spontaneous rupture of liver, rupture of external iliac vessel branch, and rupture of right renal hamartoma.

CASE SUMMARY

The clinical manifestations of three patients lacked specificity, and the localization of the bleeding was not clear prior to surgery. All 4 pregnant women were successfully treated, while only one full-term infant survived.

CONCLUSION

There are diverse causes of intra-abdominal hemorrhage during pregnancy in clinic, and it is clinically characterized by acute abdominal pain during pregnancy. Clear diagnosis before surgery is rather difficult. Early diagnosis, timely and appropriate treatment and surgery, and multidisciplinary cooperation are key to saving pregnant females’ lives and improving the outcomes of perinatal infants.

Keywords: Intra-abdominal hemorrhage; Pregnancy; Case report; Complication; Spontaneous rupture; Uterine

Core tip: Intra-abdominal hemorrhage during pregnancy is clinically rare, which is dangerous. The disease is characterized by high perinatal mortality, and delayed treatment can even lead to maternal death. Thus, obstetricians need to be vigilant in clinical work, especially for patients with high-risk factors, such as HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome, endometriosis, and multiple abdominal surgery history. Early diagnosis, timely surgery, and multidisciplinary cooperation are the keys to save maternal life and improve perinatal outcomes.