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Splenic artery aneurysms during pregnancy: An obstetric nightmare
Yifat Wiener1, Roni Tomashev1, Ortal Neeman1
1Departments of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Zerifin, 70300, Israel.
Summary
Pregnancy with splenic artery aneurysms (SAA) presents serious risks. Management varies from conservative surveillance to emergency surgery, impacting maternal and fetal outcomes.
Area of Science:
- Vascular Surgery
- Maternal-Fetal Medicine
- Radiology
Background:
- Splenic artery aneurysms (SAA) are rare but can pose significant risks during pregnancy.
- Timely diagnosis and appropriate management are crucial for maternal and fetal well-being.
Observation:
- Three cases of SAA diagnosed during pregnancy are presented.
- Case 1: Ruptured SAA in a twin pregnancy led to maternal and fetal demise.
- Case 2: SAA rupture at 27 weeks' gestation required emergency cesarean and splenectomy.
- Case 3: Asymptomatic SAAs diagnosed at 25 weeks' gestation managed conservatively with delivery at 34 weeks and postpartum embolization.
Findings:
- Ruptured SAA during pregnancy can have catastrophic outcomes, including death.
- Conservative management with close surveillance is a viable option for asymptomatic SAAs.
- Surgical or interventional treatment may be necessary in cases of rupture or high risk.
Implications:
- Obstetricians and healthcare providers must maintain a high index of suspicion for SAA in pregnant patients with abdominal pain and hemodynamic instability.
- Individualized management strategies are essential for pregnant patients with SAA, balancing risks and benefits.
- Awareness of SAA diagnosis and management options can improve maternal and fetal outcomes.
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