Cover Image




Spontaneous rupture of utero-ovarian vessels is a potentially lethal complication of pregnancy. There has been only about 150 cases reported in the literature . Spontaneous hemoperitoneum may develop from rupture of various           abdominal or pelvic viscera like spleen, liver and also uterus, from the utero- ovarian vessels and rarely from pelvic  endometrial implants. Here we report a case of 27 yr old primigravida at 39weeks and 2 days gestation with gestational hypertension who was admitted for safe confinement. Labour was induced in view of elevated blood pressure. Patient   developed sudden hypotension and tachycardia in the second stage of labour. Since the pervaginal examination at that time showed a fully dilated cervix with the vertex at plus 2 station vaccum was applied and a live male baby weighing 3 kgs was delivered vaginally. Bleeding was within normal limits but her blood pressure failed to rise inspite of adequate IV fluids. USG abdomen done showed frank hemoperitoneum.             Emergency laparotomy was done a profusely bleeding vessel from the posterior wall of the uterus was identified and the same was ligated. This case has been reported for its extreme rarity. The etiology of spontaneous rupture of           utero-ovarian vessels during pregnancy remains poorly   understood. However, several etiologic hypothesis have been postulated, based on the previously reported cases like  arteriovenous malformations, uterine artery aneurysm, endometriosis, increase in venous pressure (especially during labour), free anastomosis of uterine and ovarian vessels within broad ligament, absence of valves in ovarian veins and weakness of the vessels. Differential diagnosis may include placental abruption, uterine rupture, abdominal pregnancy, spontaneous rupture of maternal umbilical vein or aneurysmal vessels, rupture of liver or spleen or their vasculature, appendix rupture and HELLP syndrome .The diagnosis of this condition is usually made only during laparotomy.


Full Text:



Yida Fan, GonçaloInocêncio, Sara Azevedo, Maria JoãoCarinhas, Olinda Rodrigues. Spontaneous rupture of utero-ovarian vessels in pregnancy. ActaObstetGinecol Port 2013; 7(3):215-218

.Lajtman E, Mlyncek M, Uharcek P, Urban M. Spontaneous rupture of uterine vessels during pregnancy in a patient with previous endometriosis. CeskaGynekol. 2011;76(2):161-3

Cole M,Elton C, BosioP,Waugh JJ Spontaneous rupture of utero-ovarian vessels in labour–a rare case of obstetric hemoperitoneum. J ObstetGynaecol 2005;25(3):301-3.

Gard M, Hudeyin S, Aquilina J Silent, massive hemoperitoneum during labour secondary to a spontaneous rupture of a utero-ovarian vessel. J ObstetGynaecol2003 ;23(2):208–9.

Moreira A, Reynolds A, Baptista P, Costa A, Bernardes J Case report: intra-partum útero-ovarian vessels rupture. Arch GynecolObstet 2009;279:583-5.

Hashimoto K, Tabata C, Ueno Y, Fukuda H, Shimoya K, Murata Y. Spontaneous rupture of uterine surface varicose veins in pregnancy: a case report. J Reprod Med. 2006;51(9):722-4.

Nahar K, Begum H, Khatun M. Spontaneous hemoperitoneum from a ruptured superficial uterine vessel in third trimester of pregnancy. Bangladesh J obstet Gynecol. 2008;23(1):32-4.

Choobun T, Pinjaroen S, Getpook C. Spontaneous intra-abdominal bleeding during pregnancy. J Med Assoc Thai. 2006;89(7):1044-6.

Giulini S, Zanin R, Volpe A. Hemoperitoneum in pregnancy from a ruptured varix of broad ligament. ArchGynecolObstet 2010;282:459–61.

Salama S, Nizard J, Camus E, Ville Y. Spontaneous hemoperitoneum after the second trimester of pregnancy. Diagnosis and management.Eur J ObstetGynecol ReprodBiol 2009;142:81–2.

Nishi H, Funayama H, Fukumine N et al.Rupture of preg- Spontaneous rupture of utero-ovarian vessels in pregnancy 218 ActaObstetGinecol Port 2013;7(3):215-218 noncommunicating rudimentary uterine horn with fetal salvage: a case report. Arch GynecolObstet 2003; 268:224–6.

Safioleas MC, Moulakakis KG. A rare cause of intraabdominal hemorrhage: spontaneous rupture of the splenic vein. ActaChirBelg 2006;106:237–9.

MantymaaML,Ekblad U. Spontaneousrupture of liver during pregnancy. Ann ChirGynaecolSuppl 1994; 208:91–3. 20. Krasuski P, Poniecka A, Gal E, Wali A. Intrapartum spontaneous rupture of liver hemangioma. J MaternFetal Med 2001;10:290–2.


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

An Initiative of The Tamil Nadu Dr MGR Medical University