Pregnancies complicated by spontaneous abdominal wall hematoma (SAWH) frequently manifest as an acute abdomen, thereby heightening the likelihood of misdiagnosis or delayed diagnosis. This article presents a case study involving a 33-year-old pregnant woman diagnosed with antiphospholipid syndrome, who experienced SAWH in the later stages of pregnancy as a consequence of coughing, ultimately necessitating emergency cesarean section for diagnosis and treatment. The objective of this study is to furnish diagnostic and therapeutic insights and recommendations for pregnancies complicated by SAWH. Literature review was searched in both domestic and international sources, to examine the management strategies for pregnant women with SAWH. It is imperative to exercise caution when managing pregnant patients exhibiting bleeding tendencies and severe cough. Once a hematoma is confirmed, treatment alternatives should be carefully evaluated in accordance with the patient's specific condition, potentially necessitating the consideration of pregnancy termination.

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