HEMORRHAGIC CORPUS LUTEUM: CLINICAL MANAGEMENT UPDATE (review of literature)

Background: Hemorrhagic corpus luteum (HCL) is an ovarian cyst formed after ovulation and caused by spontaneous bleeding into a corpus luteum (CL) cyst. When HCL rupture happens, a hemoperitoneum results. Clinical symptoms are mainly due to peritoneal irritation by the blood effusion. The differential diagnosis is extensive and standard management is not defined.
Aim of the study: authors elaborated a comparison of differential diagnosis and therapeutic modalities from laparoscopic approach to nonsurgical, medical options, since hemorrhage from HCL is often self-limiting.
Material & Methods: authors reviewed all data implicated with the development of HCL, trying to give homogeneity to literature data.
Results: authors analyzed extensive literature data and subdivided the medical approach in many topics. Wait-and-see attitude avoids unnecessary laparoscopic surgery using supportive therapies (antifibrinolytic, analgesics, liquid infusion, transfusions and antibiotic prophylaxis). Surgical therapy: the operative management should be laparoscopic, with surgical options like luteumectomy, ovarian wedge-shaped excision or oophorectomy. Prevention: the possibility to preserve fertility is essential, mainly in patients with bleeding disorders or undergoing anticoagulant therapy; therefore, they need estro-progestinics or GnRH analogues to prevent ovulation and avoid further episodes of HCL.
Conclusion: This review will aid physicians to make an early diagnosis of HCL, to avoid unnecessary surgery and use the most effective treatment.