Abstract
A multiparous woman at 27 weeks gestation presented with hemodynamic instability and nonreassuring fetal heart tones, prompting emergency cesarean delivery. Intraoperatively, hemoperitoneum was noted without pelvic source. Postoperatively, she deteriorated, necessitating exploratory laparotomy. A ruptured splenic vein pseudoaneurysm was identified and splenectomy was performed. Both mother and infant recovered and were discharged in stable condition. This case report illustrates a rare, life-threatening cause of intra-abdominal hemorrhage in pregnancy treated with surgical exploration, emphasizing the need for rapid diagnosis and multidisciplinary management.