Splenic thrombosis complicating pregnancy in patients with poor obstetrical outcome. A report of four cases

The association of pregnancy and splenic vein thrombosis is rare. The authors describe four patients who had acute painful splenomegaly in association with pregnancy. All patients had a slightly elevated platelet count in the nonpregnant state and had at least one spontaneous abortion. One patient had transient neurologic symptoms, and two others had a history of gastric ulcer. The splenic thrombosis occurred in the 9th (in two cases) and in the 13th week of gestation (in two cases), and 1 week after abortion (in two cases). Three patients underwent splenectomy and one refused it. All patients had persistent thrombocythemia after the splenectomy. In three patients the platelet count reversibly dropped at least 50% during pregnancy. Of their 19 pregnancies, one resulted in normal birth, one in preterm birth, two in therapeutic abortion, and 15 in spontaneous abortion. Data presented suggest that the latent form or early stage of a myeloproliferative disorder may contribute to both splenic and placental thrombosis.