A CASE OF RECTUS SHEATH HEMATOMA IN PREGNANCY PRESENTING AS DEGENERATING UTERINE FIBROID

Rectus sheath hematoma is an uncommon condition characterized by acute abdominal pain and the appearance of an abdominal wall mass which leads to diagnostic dilemma in pregnant women. Here a case report of a 32 years old patient, a G4P3L3, a post caesarean pregnancy with 28 weeks gestation who presented with painless bleeding per vaginum as emergency admission. After stabilization and sonological evaluation she was diagnosed as a case of placenta praevia with degenerating fibroid and was managed conservatively. After 4 weeks admission, emergency caesarean section was performed for severe bout of bleeding per vaginum at 32 weeks which revealed a 20x30 cm rectus sheath hematoma in right side anterior abdominal wall. Mother recovered well. Both mother and child were discharged in good health. Rectus sheath hematoma can mimic many other clinical conditions and high index of suspicion should be maintained by the clinician to identify this condition and potentially manageable entity. Keywords: Rectus sheath hematoma (RSH), pregnancy, fibroid uterus, Ultrasonogram (USG)