Introduction: Diaphragmatic hernia is a condition in which abdominal contents enter the thoracic cavity through an abnormal opening in the diaphragm. Though diaphragmatic hernia in pregnancy is a rare occurrence it imposes challenges in terms of mode and time of delivery along with repair of hernia.

Case Report: A 34-year female G2 P1 L1 with 37 weeks 4 days gestational age presented in latent labour. Patient had undergone an Emergency LSCS with B/L Tubectomy under General Anaesthesia anda live male baby of birth weight 3.74 kgs was delivered. After extubation the patient had one episode of drop in saturation and oxygen supplementation was started immediately and patient was shifted to icu for observation.

A chest x-ray was done which showed bowel loops in the thoracic cavity. Later an HRCT was done confirming large defects of 5 x 7 cm of stomach, small bowel loops, large bowel loops and mesentery herniating into the left hemithorax with mild mediastinal shift to right and complete collapse of left lung suggesting diaphragmatic hernia. There was no evidence of a gastric volvulus or bowel ischemia.

Patient gives history of abdominal pain radiating to back and thigh along with fever and dry cough since 2 days. No history of chest pain, breathlessness, palpitations, epigastric pain, nausea, vomiting, headache, blurring of vision or burning micturition. No significant past or family history. General surgery and pulmonology opinion was taken which explained the need for cardio thoracic surgery intervention and the patient was referred to higher centre.

Conclusion: Diaphragmatic hernia complicating pregnancies are rare in occurrence imposing severe complications. Early diagnosis clinically and radiologically should be evaluated in pregnant women having gastrointestinal symptoms not responding to standard treatments.

Key Message: Usually diaphragmatic hernia presents in early childhood and needs surgical intervention. This was a rare presentation in the third trimester of pregnancy with mild gastrointestinal symptoms. In diaphragmatic hernia the most complicating symptom is obstruction which need immediate surgical intervention.