Spontaneous broad ligament hematoma in a patient with preterm labour

A 32 year old lady at 29 weeks of gestation presented with history of acute onset abdominal pain and was managed with tocolysis and steroids as a diagnosis of preterm labour was made. During her stay in the hospital she developed preterm prelabour rupture of membranes four days after admission and she underwent an emergency caesarean section for non-reassuring fetal status. Intraoperatively there was hemoperitoneum and hematoma contained in the left broad ligament and uterovesical fold of peritoneum with active bleeding from the left uterine vessels. The uterus was unicornuate with left fallopian tube and left ovary missing. Uterus was adherent to the bowel posteriorly with endometriotic adhesions. Conclusion Intrapartum spontaneous rupture of uterine vessels is a rare obstetrical emergency that has to be borne in mind when a pregnant patient presents with an acute abdomen since it can be lethal and may require rapid resuscitation and surgical management.