Haemoperitoneum associated with ovulation in women with bleeding disorders: the case for conservative management and the role of the contraceptive pill

Haemoperitoneum secondary to ruptured corpus luteum is a rare complication for women on anticoagulants and with certain congenital bleeding disorders. A surgical approach is often taken, leading to oophorectomy in many cases. We describe three patients presenting with haemoperitoneum in association...

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Bibliographic Details
Published in:Haemophilia : the official journal of the World Federation of Hemophilia 2007-01, Vol.13 (1), p.93-97
Main Authors: PAYNE, J. H., MACLEAN, R. M., HAMPTON, K. K., BAXTER, A. J., MAKRIS, M.
Format: Article
Language:English
Subjects:
Adult
Blood Coagulation Disorders - complications
Blood Coagulation Disorders - drug therapy
Contraceptives, Oral, Hormonal - therapeutic use
Corpus Luteum - injuries
Factor VII Deficiency - complications
Factor X Deficiency - complications
Female
haemoperitoneum
haemophilia
Hemoperitoneum - drug therapy
Hemoperitoneum - etiology
Hemoperitoneum - prevention & control
Humans
ovulation
Ovulation - drug effects
Rupture, Spontaneous
Sitosterols - blood
von Willebrand's disease
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Summary:Haemoperitoneum secondary to ruptured corpus luteum is a rare complication for women on anticoagulants and with certain congenital bleeding disorders. A surgical approach is often taken, leading to oophorectomy in many cases. We describe three patients presenting with haemoperitoneum in association with factor VII deficiency, factor X deficiency and sitosterolaemia. In two of the patients, recurrent episodes occurred prior to introduction of the oral contraceptive pill. Conservative management with blood product and factor concentrate support was successful in avoiding surgery in three of the five episodes of bleeding. These cases demonstrate that preservation of ovarian function is possible with a conservative approach and recurrent episodes may be prevented by suppression of ovulation.
ISSN:1351-8216
1365-2516
DOI:10.1111/j.1365-2516.2006.01399.x