{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:56:13Z","timestamp":1761897373380,"version":"3.44.0"},"reference-count":14,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,10,13]]},"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p>We report a case of idiopathic spontaneous intraperitoneal haemorrhage (ISIH) in a 31-year-old patient at 37 weeks gestation in her second pregnancy. The patient presented to the labour ward with abdominal pain and uterine contractions. The initial complain was of sudden onset, severe sharp pain in left iliac fossa. She started having uterine contractions within 30\u2009min of her presentation. Examination confirmed early labour with a footling breech presentation. Urgent caesarean section was performed that confirmed peritoneal bleeding of unknown origin with safe delivery of the baby. Mother and baby were safely discharged on day 5. \u2018Abdominal apoplexy\u2019 (ISIH), is a rare obstetric emergency with increased risk of fetal and maternal morbidity and mortality. With various clinical presentations as a possibility, diagnosis is challenging. High index of suspicion with prompt management of suspected cases can be pivotal life saving measure for the fetus and mother.<\/jats:p>","DOI":"10.1136\/bcr-2020-235946","type":"journal-article","created":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T17:11:00Z","timestamp":1604077860000},"page":"e235946","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Abdominal apoplexy during pregnancy"],"prefix":"10.1136","volume":"13","author":[{"given":"Jasmeet","family":"Kumari","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, Our Lady of Lourdes, Drogheda, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosemary","family":"Harkin","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Our Lady of Lourdes, Drogheda, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,10,30]]},"reference":[{"key":"2025082706523213000_13.10.e235946.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2009.03.091"},{"key":"2025082706523213000_13.10.e235946.2","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1111\/1471-0528.14371","article-title":"Spontaneous haemoperitoneum in pregnancy and endometriosis: a case series","volume":"124","author":"Lier","year":"2017","journal-title":"BJOG"},{"key":"2025082706523213000_13.10.e235946.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2007.02.009"},{"key":"2025082706523213000_13.10.e235946.4","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1016\/j.fertnstert.2016.05.025","article-title":"Severe spontaneous hemoperitoneum in pregnancy may be linked to in vitro fertilization in patients with endometriosis: a systematic review","volume":"106","author":"Brosens","year":"2016","journal-title":"Fertil Steril"},{"key":"2025082706523213000_13.10.e235946.5","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1097\/00000658-193105000-00013","article-title":"Intra-abdominal apoplexy","volume":"93","author":"Green","year":"1931","journal-title":"Ann Surg"},{"key":"2025082706523213000_13.10.e235946.6","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1016\/S0002-9378(16)39178-5","article-title":"Hemorrhage from ruptured utero-ovarian veins during pregnancy; 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