Enoxaparin-Induced Abdominal Wall Haematoma in Pregnancy: A Case Report

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.