BACKGROUND:

The rupture of an utero-ovarian varicose vein during pregnancy is an infrequent event but it can have important implications for maternal and neonatal morbidity and mortality. It can occur at any time during pregnancy, although its frequency is increased in the third trimester and during labor.

CLINICAL CASE:

A single gestation of 39 weeks, with regular monitoring without incidents, who went to the emergency department for intense and generalized abdominal pain of two hours of evolution. The patient presented hypotension and tachycardia and moderate anemia with a hemoglobin of 8.9 g/dL and a hematocrit of 35%. Fetal monitoring showed fetal tachycardia with decreased variability and subsequent bradycardia. It was decided to end the pregnancy by an urgent caesarean section where a hemoperitoneum of approximately 1 liter was observed. As well, and active bleeding resulting from the rupture of a posterior uterine wall vein was noted and controlled with hemostatic sutures. The maternal and neonatal results were favorable.

CONCLUSIONS:

Spontaneous rupture of utero-ovarian varicose veins can be the cause of massive hemoperitoneum and can maternal and fetal serious consequences. A promptly suspected diagnosis and an urgent laparotomy are vital to restrain bleeding and achieve a good maternal and fetal result.

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