Ndukwu Nnamdi C, Joshi Ritesh, Rasool Irfana, Basak Sambita
Obstetrics and Gynaecology, University Hospital of Northampton, Northamptonshire, GBR.
Obstetrics and Gynaecology, Federal Medical Centre, Umuahia, NGA.
Cureus. 2025 Jun 8;17(6):e85548. doi: 10.7759/cureus.85548. eCollection 2025 Jun.
Rectus sheath haematoma (RSH) is an uncommon but potentially serious condition in pregnancy, often associated with anticoagulant use. Diagnosis can be challenging as it can mimic other obstetric or surgical emergencies. With the increasing use of low molecular weight heparins in pregnancy, awareness of this complication is essential. We present a case of enoxaparin-induced RSH in a 42-year-old grand multiparous woman with a history of four previous caesarean sections, who presented at 36 +3 weeks of gestation with signs and symptoms of an acute abdomen. A significant drop in haemoglobin levels, worsening clinical symptoms, and her obstetrics history prompted us to proceed with a caesarean section, during which an RSH was identified. The caesarean section was completed successfully, and the RSH was managed conservatively. She made a progressive and satisfactory recovery with no further complications. By sharing our experience, we highlight the diagnostic and management challenges of this condition to improve clinical awareness among obstetricians.
腹直肌鞘血肿（RSH）在孕期并不常见，但可能是严重情况，常与抗凝药物使用有关。诊断具有挑战性，因为它可能与其他产科或外科急症相似。随着孕期低分子量肝素使用的增加，认识到这种并发症至关重要。我们报告一例42岁的经产妇发生依诺肝素诱导的腹直肌鞘血肿，该患者既往有四次剖宫产史，在妊娠36 +3周时出现急腹症的体征和症状。血红蛋白水平显著下降、临床症状恶化以及她的产科病史促使我们进行剖宫产，术中发现腹直肌鞘血肿。剖宫产手术成功完成，腹直肌鞘血肿采用保守治疗。她逐渐康复且情况良好，无进一步并发症。通过分享我们的经验，我们强调了这种情况的诊断和管理挑战，以提高产科医生的临床认识。
