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Splenic artery aneurysm rupture in pregnancy
Jennifer Fong Ha1, Michael Phillips, Kingsley Faulkner
1Department of General Surgery, University of Western Australia, St John of God Hospital (Subiaco), Subiaco, WA 6003, Australia. jenha81@yahoo.com.au
Summary
Splenic artery aneurysms (SAAs) are most common in pregnant women and often rupture, leading to high maternal and fetal mortality. Early diagnosis and management are crucial for improving outcomes in this high-risk group.
Area of Science:
- Vascular Surgery
- Obstetrics and Gynecology
- Radiology
Background:
- Splenic artery aneurysm (SAA) is the most frequent visceral artery aneurysm.
- SAAs disproportionately affect younger women, with 95% diagnosed during pregnancy.
- Rupture carries a high risk of maternal and fetal mortality.
Purpose of the Study:
- To review patient and SAA characteristics.
- To analyze clinical presentations, management, and outcomes of ruptured SAAs.
- To highlight the diagnostic challenges and clinical significance of SAAs in pregnancy.
Main Methods:
- Literature search for studies on splenic artery aneurysms.
- Analysis of patient demographics, aneurysm size, and rupture status.
- Review of management strategies and associated mortality rates.
Main Results:
- 32 patients were analyzed, with a mean age of 27.9 years.
- Most SAAs (96.9%) were diagnosed after rupture, often spontaneously.
- Maternal and fetal mortality rates were 21.9% and 15.6%, respectively.
Conclusions:
- Most splenic artery aneurysms are diagnosed only after rupture during pregnancy.
- Ruptured SAA should be considered in pregnant patients with unexplained severe abdominal pain.
- Prompt diagnosis and intervention are vital to reduce maternal and fetal mortality.
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