Management of a Splenic Artery Aneurysm in the Third Trimester of Pregnancy

Abstract

Background. Splenic artery aneurysm (SAA) is a rare but potentially fatal complication associated with high maternal and fetal mortality when occurring during pregnancy. Case. A 29-year-old G4P3003 at 34 4/7 weeks of gestation was admitted with left upper quadrant pain and newly diagnosed SAA in the hilum. She was scheduled for embolization of the SAA but the night before went into labor. A multidisciplinary team discussion was held, and the patient underwent successful primary low transverse c-section via Pfannenstiel skin incision followed by laparoscopic splenectomy under general anesthesia. She delivered a male newborn with birth weight of 2855 and Apgar score of 8/5. Summary and Conclusion. Early diagnosis and management of SAA are key for improved maternal and fetal outcomes. Our case demonstrates that through a multidisciplinary approach and anticipation of the possible clinical scenarios, good outcomes can be achieved.

Splenic artery aneurysm in obstetrical patients: A series of four cases with different clinical presentation and outcome

“…It can be a rapid process, associating with acute-onset of severe mid and left upper abdominal pain, hemodynamic instability, and massive hemoperitoneum. 2,16 However, SAA rupture can also occur in two stages. If so, the initial clinical presentation is deceitful because the hemorrhage is contained in the lesser sac by clots blocking the foramen of Winslow and presents with vague symptoms, such as nausea, general malaise, and mild to moderate upper abdominal pain, with no evidence of free intraperitoneal fluid at sonography.…”

“…It can be a rapid process, associating with acute‐onset of severe mid and left upper abdominal pain, hemodynamic instability, and massive hemoperitoneum 2,16 . However, SAA rupture can also occur in two stages.…”

Spontaneous subdural haemorrhage in an in vitro fertilisation conceived triplet pregnancy - A case study

“…Increased oestrogen, progesterone and relaxin levels during pregnancy are associated with structural changes in the systemic vasculature. [ 1 ] This effect might be more pronounced in our patient since it was a triplet pregnancy. [ 2 ] Progesterone supplementation is an essential aspect of IVF pregnancy to support the luteal phase and create a more favourable environment for embryo implantation.…”