Bleeding disorders in patients with hemoperitoneum due to corpus luteum cyst rupture: a retrospective analysis and screening considerations

Aims: Hemoperitoneum due to corpus luteum cyst rupture (CLCR) can be a life-threatening condition, especially in patients with underlying bleeding disorders (BDs). Identifying the prevalence of BDs in such cases may aid in early diagnosis and management. This study aims to evaluate and determine the prevalence and role of congenital and acquired BDs in patients presenting with hemoperitoneum secondary to CLCR. Methods: A retrospective case-control study was conducted on 81 patients with hemoperitoneum caused by CLCR, managed at our tertiary care center. The presence of BDs was assessed using the International Society on Thrombosis and Haemostasis Bleeding Assessment Tool (ISTH-BAT). Results: Among the 81 patients, 76.5% (n=62) had an ISTH-BAT score <6, while 23.5% (n=19) had a score ≥6. Among those with an ISTH-BAT score ≥6, 7 patients (36.9%) were diagnosed with congenital or acquired BDs, with 6 having a prior diagnosis, and 1 being newly diagnosed. Compared to the ISTH-BAT <6 group, patients with a score ≥6 had lower initial hemoglobin levels (p=0.02) and higher activated partial thromboplastin time levels (p<0.001). Surgical intervention was significantly more frequent in patients with ISTH-BAT ≥6 (47.4%) than in those with a lower score (8.1%) (p<0.001), particularly among individuals with BDs. Conclusions: This study highlights the clinical significance of the association between BDs and hemoperitoneum due to CLCR, emphasizing the importance of considering BD screening in the management of affected patients.