Published: 2017-10-28

Ruptured corpus luteum cyst in women on anticoagulant: conservative or surgical management a clinical dilemma

Manika Agarwal, Jupirika E. Prybot, Ashish Dhirasaria


Ruptured corpus luteum cyst is a common finding in women of the reproductive age group, but hemoperitoneum in a case of reputured corpus luteum cyst in women on anticoagulants is an uncommon finding. Thus, management in such cases can be done by dose adjustment of anticoagulants. A woman had come to the emergency with complaints of pain distention of abdomen. Her USG showed adenexal mass with hemoperitoneum. She was on anticoagulants. Her coagulation profile was deranged. Patient was managed conservatively with dose adjustment and transfusion of blood and fresh frozen plasma. Hemoperitoneum due to ruptured corpus luteum cyst in reproductive age group have a similar presentation with ectopic pregnancy. In women in this age group pregnancies should be ruled out. Patients on anticoagulants may not require laparotomy and can be managed conservatively.


Anticoagunants, Corpus luteum, Hemoperitoneum

Full Text:



Stenchever M. Comprehensive gynecology. 5th ed. USA, Mosby;2007:460-1.

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

Gupta N, Dadhwal V, Deka D, Jain SK, Mittal S. Corpus luteum hemorrhage: rare complication of congenital and acquired coagulation abnormalities. J Obstet Gynecol Res. 2007 Jun 1;33(3):376-80.

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 Jan 1;13(1):93-7.

Sun WC, Li W, Chen QH, Tong JY. Corpus luteum haemorrhage a patient with aplastic anaemia. Obstet Gynecol Res. 2013;39(1):399-401.

Cetinkaya SE, Pabuccu EG, Ozmen B, Dokmeci F. Recurrent massive hemoperitoneum due to ovulation as a clinical sign in congenital afibrinogenemia. Acta Obstet Gynecol Scand. 2011 Feb 1;90(2):192-4.

Ara A, Malik R, Malla VG. Haemoperitoneum due to ruptured corpus luteum! Managed conservatively-2 case reports and review of literature. Int J Reprod Contracept Obstet Gynecol. 2016 Oct;5(10):3622-5.

Gupta A, Gupta S, Manaktala U. 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.

Tanaka T. Non-operative management of idiopathic ovarian hemorrhage with massive intraabdominal hemorrhage. Osaka City Med J. 1997;43:7-14.

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