Changing trends in the management of corpus luteum haemorrhage


  • Avantika Gupta Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
  • Deepthi Nayak Department of Obstetrics and Gynecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, Tamil Nadu, India
  • Purnima Tiwari Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India



Corpus luteal cyst, Hemoperitoneum, Cyst rupture, Laparotomy, CT scan


Corpus luteal haemorrhage usually causes only mild symptoms and resolve spontaneously, however, it can cause massive bleeding in certain patients with coagulation or bleeding disorders. Over a decade, the management of corpus luteum haemorrhage has shifted from surgical to conservative management. This article focuses on selection of patients for conservative management so that the morbidities associated with the surgery can be avoided. Conservative management includes optimization of oxygen carrying capacity of blood, correction of coagulopathy and appropriate analgesia. It can be recurrent in certain high-risk group of patients who will need long term suppression of ovulation.


Bottomley C, Bourne T. Diagnosis and management of ovarian cyst accidents. Best Pract Res Clin Obstet Gynaecol. 2009;23(5):711-24.

Gupta A, Gupta S, Manaktala U, Gupta MM, Solanki V. Conservative management of corpus luteum haemorrhage in patients on anticoagulation: a report of three cases and review of literature. Arch Gynecol Obstet. 2015;291(2):427-31.

Semchyshyn S, Zuspan FP. Ovarian hemorrhage due to anticoagulants. Am J Obstet Gynecol. 1978;131:837-44.

Tresch DD, Halverson G, Blick M, Keelan MH Jr. Ovarian (corpus luteum) hemorrhage during anticoagulation therapy. Ann Intern Med. 1978;88:642-6.

Yamakami LY, Araujo DB, Silva CA, Baracat EC, Carvalho JF. Severe hemorrhagic corpus luteum complicating anticoagulation in antiphospholipid syndrome. Lupus. 2011;20:523-6.

Kim JH, Jeong SY, Cho DH. Massive hemoperitoneum due to a ruptured corpus luteum cyst in a patient with congenital hypofibrinogenemia. Obstet Gynecol Sci. 2015;58:427-30.

Beyth RJ, Quinn LM, Landefeld CS. Prospective evaluation of an index for predicting the risk of major bleeding in outpatients treated with warfarin. Am J Med. 1998;105:91-9.

Cretel E, Cacoub P, Huong DL, Gompel A, Amoura Z, Piette JC. Massive ovarian haemorrhage complicating oral anticoagulation in the antiphospholipid syndrome: a report of three cases. Lupus. 1999;8:482-5.

Palareti G, Leali N, Coccheri S, Poggi M, Manotti C, Angelo A, et al. Bleeding complications of oral anticoagulant treatment: an inception-cohort, prospective collaborative study (ISCOAT). Italian Study on Complications of Oral Anticoagulant Therapy. Lancet. 1996;348:423-8.

Jamal A, Mesdaghinia S. Ruptured corpus luteum cysts and anticoagulant therapy. Int J Gynaecol Obstet. 2002;76:319-20.

11. Jain KA. Sonographic spectrum of hemorrhagic ovarian cysts. J Ultrasound Med. 2002;21:879-86.

Liu X, Song L, Wang J, Liu Q, Liu Y, Zhang X. Diagnostic utility of CT in differentiating between ruptured ovarian corpus luteal cyst and ruptured ectopic pregnancy with hemorrhage. J Ovarian Res. 2018;11:5.

Fiaschetti V, Ricci A, Scarano AL, Liberto V, Citraro D, Arduini S, et al. Hemoperitoneum from corpus luteal cyst rupture: a practical approach in emergency room. Case Rep Emerg Med. 2014;2014:252657.

Hallatt JG, Steele CH, Snyder M. Ruptured corpus luteum with hemoperitoneum: a study of 173 surgical cases. Am J Obstet Gynecol. 1984;149:5-9.

Raziel A, Ron-El R, Pansky M, Arieli S, Bukovsky I, Caspi E. Current management of ruptured corpus luteum. Eur J Obstet Gynecol Reprod Biol. 1993;50:77-81.

Murao H, Kinjyo, K. Demura T. Conservative therapy for corpus luteum hemorrhage, a review of 116 cases. Clin Gynecol Obstet. 1994;48:568-72.

Sikka P, Joshi B, Aggarwal N, Suri V. Corpus Luteal Hemorrhage in Coagulopathy; A Case Report with Review of Treatment Modalities. Austin J Obstet Gynecol. 2015;2:1038.

Kim JH, Lee SM, Lee JH, Jo YR, Moon MH, Shin J, et al. Successful conservative management of ruptured ovarian cysts with hemoperitoneum in healthy women. PLoS One. 2014;9:91171.

Spinelli C, Giacomo M, Mucci N, Massart F. Hemorrhagic corpus luteum cysts: an unusual problem for pediatric surgeons. J Pediatr Adolesc Gynecol. 2009;22:163-7.

Fong YI, Chua HW, Singh C. Diagnostic Dilemma: Acute Abdomen from Ruptured Corpus Luteum Requiring Surgical Intervention in Young Women. Thai J Obstetrics Gynecol. 2013;21:80-6.

Lee MS, Moon MH, Woo H, Sung CK, Jeon HW, Lee TS. Ruptured Corpus Luteal Cyst: Prediction of Clinical Outcomes with CT. Korean J Radiol. 2017;18:607-14.

Lee JK, Bodur S, Guido R. The management of gynecological hemoperitoneum found to be associated with a ruptured corpus luteum cyst. Gynecological Surgery 2016;13:305-11.

Bondagji NS. Conservative management of massive intraperitoneal hemorrhage from corpus luteum cyst in a patient on anticoagulant therapy post Fontan procedure. J King Abdulaziz University- medical sciences 2011;18:93-9.

Payne JH, Maclean RM, Hampton KK, Baxter AJ, Makris M. Haemoperitoneum associated with ovulation in women with bleeding disorders: the case for conservative management and the role of the contraceptive pill. Haemophilia. 2007;13:93-7.

Teng SW, Tseng JY, Chang CK, Li CT, Chen YJ, Wang PH. Comparison of laparoscopy and laparotomy in managing hemodynamically stable patients with ruptured corpus luteum with hemoperitoneum. J Am Assoc Gynecol Laparosc. 2003;10:474-7.

Takeda A, Sakai K, Mitsui T, Nakamura H. Management of ruptured corpus luteum cyst of pregnancy occurring in a 15-year-old girl by laparoscopic surgery with intraoperative autologous blood transfusion. J Pediatr Adolesc Gynecol. 2007;20:97-100.

Yamada T, Okamoto Y, Kasamatsu H, Mori H. Intraoperative autologous blood transfusion for hemoperitoneum resulting from ectopic pregnancy or ovarian bleeding during laparoscopic surgery. JSLS. 2003;7:97-100.

WHO. Medical eligibility criteria for contraceptive use, 2021. Available at: publications/i/item/9789241549158. Accessed on 29 May 2021.

Connor BS, Coviello E, Fries M, John AS. Ovulation suppression to prevent hemoperitoneum and surgical menopause in anticoagulated women. JACC Case Reports 2019;1:50-4.

Sonmezer M, Atabekoglu C, Cengiz B, Dokmeci F, Cengiz SD. Depot Medroxyprogesterone Acetate in anticoagulated patients with previous haemorrhagic corpus luteum. European J Contracept Reproduct Health Care. 2005;10:9-14.

Ulrich U, Rossmanith WG. Management of peritoneal haemorrhage due to follicle rupture under anticoagulant therapy. J Endocrinol Investigat. 1994;17:351-3.






Review Articles