Intraperitoneal hemorrhage during pregnancy and parturition: Case reports and literature review

We aim to investigate the diagnosis, treatment, and prognosis of intraperitoneal hemorrhage during pregnancy and parturition. Three cases with intraperitoneal hemorrhage during pregnancy and parturition admitted to our hospital from Jan. 2008 to Jan. 2018 were included in this study. One case showed fetal distress. Abdominal ultrasonography and abdominal CT showed pyoperitoneum in 2 cases. Abdominal puncture was performed in 2 patients, and noncoagulant blood was collected. The indications of emergency caesarean section in 3 cases were intraperitoneal hemorrhage. The etiology included rupture of posterior wall of uterus, rupture of blood vessel on uterine surface, and rupture of inflammatory vessel on uterine surface, respectively. The average volume of intraperitoneal bleeding was 2630 ml, and the average transfusion volume was 1530 ml. Caesarean section, and suture hemostasis were performed in 3 cases. The gestational age of delivery were 40(+6) weeks, 40(+2) weeks, and 25(+5) weeks, respectively. There were 1 stillborn fetus and 2 live infants. All the puerperas were cured and discharged. Intraperitoneal hemorrhage in pregnancy is rare and is easily misdiagnosed. The mortality of pregnant women and perinatal infant is high. Therefore, early diagnosis, and timely operation is important.