BACKGROUND:

The spontaneous abdominal wall hematoma during pregnancy is a rare entity with nonspecific symptoms that resemble other more frequent pathologies in pregnancy. This makes difficult a proper initial diagnosis, which leads to erroneous management actions with the consequent adverse maternofetal outcomes.

OBJECTIVE:

Spread this unusual pathology in daily practice.

CLINICAL CASE:

Fourth pregnancy of 37 + 2 weeks who comes to the Emergency Room due to severe pain in the right hypochondrium of sudden onset. Regular gestational course so far. Analytics at the admission does not show alterations. Abdominal ultrasound was performed, where a heterogeneous mass of echogenic predominance was observed in the right hemiabdomen of 12x7x10 cm which appears to be located in the anterior abdominal wall. There was no vascularization inside. Single fetus in cephalic, positive heartbeat and anterior placenta well implanted. The amniotic liquid was normal. A non-stress test was performed which showed a reactive fetus, without objectifying uterine dynamics. Due to the diagnostic suspicion of spontaneous hematoma of the abdominal wall, expectant management with serial blood count controls was decided, and endovenous analgesia was established. The patient presented favorable evolution, so she was discharged on the eight day and later on week 40+3 of pregnancy she presented an eutocic delivery, without any additional incidence.

CONCLUSIONS:

It is important to include this entity within the differential diagnosis of acute abdominal pain in pregnancy in order to carry out an adequate management.

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