Rupture of splenic artery aneurysm during labor: a case report of maternal and fetal survival.
OBJECTIVE
To report a case of splenic artery aneurysm that ruptured during labor with both maternal and fetal survival.


METHODS
A 33-year-old primigravida at 42 weeks of gestation was admitted to Adan Hospital for induction of labor. Three days after induction, the patient suddenly collapsed and was found to be hypotensive. Abruptio placentae was mistakenly diagnosed, despite the absence of vaginal bleeding, and the patient was immediately taken to the operating room for emergency cesarean section. A female infant was delivered without any evidence of abruptio placentae but with 2,000 ml blood noted in the abdominal cavity. A vertical midline incision was performed and a ruptured splenic artery aneurysm was found. Proximal ligation of the splenic artery was performed followed by splenectomy. Both mother and newborn did well and were discharged on the 7th postoperative day.


CONCLUSIONS
This case illustrates the need to consider ruptured splenic artery aneurysm as part of differential diagnosis of hemoperitoneum in pregnant women. Immediate surgical intervention is needed to ensure survival of both mother and fetus.
Al Asfar
Fahad
F
Department of Surgery, Al Adan Hospital, Ministry of Health, Kuwait. msaber1110@hotmail.com
Saber
Mohamed
M
Dhar
Piyaray M
PM
Al Awadhi
Nema
N
D000328:Adult; D017542:Aneurysm, Ruptured / Q000175:diagnosis* / Q000601:surgery*; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007744:Obstetric Labor Complications / Q000175:diagnosis* / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D013157:Splenic Artery / Q000601:surgery*; D016896:Treatment Outcome