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Pregnancy with massive splenomegaly: A case series
Seema Singhal1, Kallol Kumar Roy1, Sunesh Kumar1
1Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
The National Medical Journal of India
|May 3, 2019
Summary
Pregnancy with massive splenomegaly is rare and risky for mother and fetus. Multidisciplinary care in a tertiary center improves outcomes for this challenging condition.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Hepatology
Background:
- Massive splenomegaly during pregnancy presents a rare clinical scenario.
- Associated risks to both maternal and fetal well-being are significant.
- Limited literature exists to guide management strategies.
Purpose of the Study:
- To review the clinical course and outcomes of pregnant women with massive splenomegaly.
- To identify maternal and fetal complications associated with this condition.
Main Methods:
- Retrospective review of 5 pregnant women with massive splenomegaly managed between 2015-2016.
- Analysis of pregnancy course, maternal complications, and fetal outcomes.
Main Results:
- All patients presented with anemia and thrombocytopenia.
- Etiologies included chronic malaria, cirrhosis with portal hypertension, and non-cirrhotic portal hypertension.
- Severe maternal complications occurred in 2 patients (pulmonary edema, cardiac arrest, spontaneous bacterial peritonitis).
- Common perinatal issues included intrauterine growth restriction and meconium-stained liquor.
- Two vaginal deliveries and three emergency cesarean sections were performed.
- Postpartum hemorrhage occurred in 2 patients, with prolonged hospital stays for all.
Conclusions:
- Pregnancy with massive splenomegaly is complex due to varied causes and potential adverse outcomes.
- Optimizing outcomes requires multidisciplinary care within a tertiary care setting.
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