Spleen rupture during labor

ABSTRACT

Splenic artery aneurysm is a rare condition with a prevalence of less than 1% in the general population and is more common in women; however, it is the third most common cause of intra-abdominal aneurysms and the most common among visceral arterial aneurysms1. This condition was first described by Beussier in 1770; some of the risk factors often described are fibrodysplasia, portal hypertension, splenomegaly, cirrhosis of the liver, liver transplant, pancreatitis, vasculitis, infectious mononucleosis, and pregnancy1-6.Pregnancy is considered the most important risk factor for the rupture of this aneurysm, but the true prevalence of this event is unknown2. Increased splanchnic and splenic circulation during pregnancy has been indicated as one of the main factors in the development of aneurysms. The modifications in circulation induced by estrogen and progesterone during pregnancy may also contribute to weakening blood vessel walls, especially at the bifurcations. It is speculated that the greater the woman’s parity the greater the risk of development and rupture of the aneurysm, due to the successive stresses to which the vessel wall is submitted3.The importance of an adequate diagnosis and management of this condition, despite its low prevalence, is supported by the high rates of maternal and fetal mortality, 75 and 95%, respectively3.