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20 October 2016 : Case report  USA

Intra-Amniotic Hemorrhage Imitating Gastroschisis: A Case Report and Review of the Literature

Unusual clinical course, Mistake in diagnosis, Diagnostic / therapeutic accidents, Educational Purpose (only if useful for a systematic review or synthesis)

Everett F. MagannABDEF, Kinsey I. DinnelBF, Nader Z. RabieABDE, Amanda L. ShoemakerABF, Nirvana A. ManningABF

DOI: 10.12659/AJCR.900114

Am J Case Rep 2016; 17:766-769

Abstract

BACKGROUND: A spontaneous intra-amniotic hemorrhage is rarely encountered during pregnancy. The correct diagnosis and management are problematic because of the infrequency of this condition and the high likelihood of a misdiagnosis.

CASE REPORT: A primigravida with an uncomplicated pregnancy and a normal targeted ultrasound presented late in the second trimester of pregnancy with antepartum bleeding of unknown origin. A repeat ultrasound was suggestive of an abdominal wall defect (gastroschisis). The patient continued to have antepartum bleeding and developed uterine contractions and abdominal pain necessitating frequent visits to labor and delivery. An MRI ruled out gastroschisis and diagnosed intra-amniotic hematoma. The patient presented with acute abdominal pain and was clinically considered to be having an abruption, and was delivered by cesarean. Old blood was noted in the abdominal cavity and within the uterine cavity. At the time of the cesarean, an area of intra-amniotic hematoma was identified, as well as a retroplacental blood clot.

CONCLUSIONS: An intra-amniotic hematoma is unusual and may be misdiagnosed. MRI may be helpful in determining the correct diagnosis and subsequent management.

Keywords: Hematoma, Hemorrhage, Prenatal Diagnosis, Ultrasonography, Prenatal

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923