title: Spontaneous rupture of a splenic artery aneurysm in pregnancy: report of two cases.
abstract: The spontaneous rupture of a splenic artery aneurysm during pregnancy is a rare but catastrophic event. Two cases are reported, both involving fetal death and one maternal death as well. A review of the literature covering this condition shows that mortality amongst pregnant women remains high at 75% with 95% fetal loss, which compares with a 25% mortality rate amongst non-pregnant women. Clinical presentation is often non-specific, with good haemodynamic compensation, followed by a rapid deterioration. The best investigation appears to be a diagnostic laparotomy. The discussion stresses the importance of early diagnosis faced with this serious condition, as well as the potential benefits of a prompt lower mid-line incision in terms of statistical survival for both mother and fetus.
authors.affiliation: Service d'Obstétrique-Gynécologie, Hôpital de Braine-l'Alleud-Waterloo, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Shahabi
authors.forename: J
authors.initials: J
authors.lastname: Jani
authors.forename: L
authors.initials: L
authors.lastname: Masters
authors.forename: L
authors.initials: L
authors.lastname: Cobin
authors.forename: J
authors.initials: J
authors.lastname: Greindl
mesh_terms: D000328:Adult; D017542:Aneurysm, Ruptured / Q000175:diagnosis* / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007813:Laparotomy; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000601:surgery; D011256:Pregnancy Outcome; D012422:Rupture, Spontaneous; D013157:Splenic Artery; D016216:Ultrasonography, Prenatal