LAUSR

We present a 38-year-old woman, 36þ 3 weeks pregnant, dichorionic-diamniotic gestation, who attended to the emergency system reporting pain of 36 h of evolution in the right flank. She also reported a flu-like infection with coughing fits last week. The patient was previously diagnosed of mild preeclampsia. She was hemodynamically stable. The heart rate of both foetuses showed a pattern of foetal heart rate with low acquisition. On palpation of the right hypochondrium, the patient suddenly began with very intense pain, with normal uterine tone, and a decrease in the heart rate of the first twin was observed. Suspecting severe preeclampsia with hepatic rupture (HR) an emergent caesarean section was indicated, without prior ultrasound due to suspected foetal distress.