Introduccion: se conocen alrededor de 3000 tipos de serpientes, de las cuales solo el 15% son venenosas. Dependiendo de las caracteristicas ambientales, geograficas y socio-demograficas, existen diferencias significativas en la incidencia de casos de accidentes ofidicos. Colombia reporta seis casos por cada 100.000 habitantes, 2300 casos/ano, con una mortalidad de aproximada del 5 - 6%. En la mujer gestante es un evento poco frecuente, entre 1.4% y 4%, y suele complicar seriamente a la materna y al producto de la gestacion. Lo anterior dependera de la oportunidad con que se realice el manejo adecuado y de la severidad del envenenamiento. En la actualidad no esta clara la seguridad del suero antiofidico para el producto, se ha relacionado con aborto en etapas tempranas del embarazo y muerte fetal al final del embarazo. No obstante, su administracion oportuna es la unica medida efectiva para evitar complicaciones graves y muerte materna. Caso clinico: paciente de 16 anos de edad, G2C1, con diagnostico de embarazo gemelar bicorial – biamniotico de 36 semanas y accidente ofidico tipo bothropico de 16 horas de evolucion. Miembro inferior derecho con dolor, edema grado III, rubor, calor, formacion de flictenas y equimosis en su tercio distal. Las pruebas de laboratorios senalan prolongacion de tiempos de coagulacion, elevacion de transaminasas y creatinina. Se considera presencia de envenenamiento severo y se inicia manejo con suero antiofidico. Se finaliza el embarazo por cesarea a consecuencia de disfuncion renal y hepatica materna, y manejo postoperatorio en UCI. Los productos nacen con depresion respiratoria severa, son llevados a Unidad de Cuidados Intensivos neonatales con buena evolucion y egreso hospitalario da los cinco dias. La paciente al dia siguiente de la cesarea, presenta sindrome compartimental (SC), por lo que se realiza fasciotomia. Al alcanzarse adecuada recuperacion se realiza colgajo cutaneo y luego de 27 dias de hospitalizacion se da salida. Conclusion : el accidente ofidico en el embarazo es una situacion rara, que se debe manejar de manera rapida y oportuna, con la utilizacion del suero antiofidico, si es necesario, y en la dosis adecuada. Ademas es un evento con multiples complicaciones inmediatas y tardias, tanto para la madre como para el feto. Rev.cienc.biomed. 2012;3(2):333-338 PALABRAS CLAVES Accidente ofidico; Mordedura de serpiente; Suero antiofidico; Embarazo. SUMMARY Introduction: around of 3000 types of snakes are known, from which just 15% are venomous. Depending of the environmental, geographical and socio-demographic characteristics, there are significant differences in the incidence of cases of ophidic accidents. Colombia reports 6 by each 100.000 habitants, 2.300 cases/year, with a mortality of 5.6%. In a pregnant woman it is a rare event, between 1.4% and 4%, and it usually complicates seriously to the mother and to the product of the gestation. The previous thing will depend of the opportunity with which the suitable management is fulfilled and of the severity of the poisoning. Nowadays it isn´t clear the security of the antiophidic serum for the product, it has been related with miscarriage in early stages of pregnancy and fetal death at the end of the pregnancy. Nevertheless, its appropriate administration is the unique effective measure to avoid serious consequences and maternal death. Clinical case: patient of 16 years old, G2 C1, with diagnosis of diamniotic dichorionic twin pregnancy of 36 weeks and ophidic accident of bothropic type of 16 hours of evolution. Right inferior limb with pain, edema grade III, blush, heat, formation of flictenas and ecchymosis in its distal third. Laboratory tests indicate prolongation of the clotting time, elevated transaminases and elevated creatinine. It is considered the presence of severe poisoning and management with antiophidic serum is initiated. The pregnancy is finished by cesarean as a result of maternal renal and hepatic dysfunction, and postoperative care in UCI. The products are born with severe respiratory depression; they are carried to neonatal intensive care unit with good evolution and hospital expenditure to the five days. Next day to the cesarean, the patient presents compartment syndrome, for which fasciotomy is fulfilled. When the patient gets adequate recovery, it is done a cutaneous hanging tatter and after 27 days of hospitalization one gives exit with adequate recovery. Conclusion: ophidic accident in pregnancy is a rare situation, which should be managed in a fast and opportune way with the use of antiophidic serum if it is necessary and in the adequate doses. Moreover, it is a serious event with numerous immediate and belated complications for the mother and for the fetus. Rev.cienc.biomed. 2012;3(2):333-338 KEYWORDS Snake bites; Snake envenomation, Antivenins; Pregnancy