TITLE:
Spontaneous Rupture of Spleen in a Pregnant Armenian Woman with Favourable Pregnancy Outcome: Case Report
AUTHORS:
Norayr Ghukasyan
KEYWORDS:
Pregnancy, Splenic Rupture, Obstetric Emergency
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.2,
February
25,
2021
ABSTRACT: Background: Spontaneous or traumatic rupture of spleen in pregnancy is a rare event
with catastrophic consequences. This report presents a case of spontaneous
splenic rupture of a pregnant woman with thrombophilia in complicated somatic
history and successful cesarean section with maternal and infant survival. Case: A 28-year-old Armenian woman at 35 weeks of gestation presented to the
Emergency Department at “Erebouni” medical center in Yerevan, Armenia with
sharp pain in the epigastric region, general weakness and worsening condition.
The patient was immediately transferred to the operating room. All
clinical-laboratory examinations were urgently carried out, the fetus condition
began to be assessed under the control of the CT. She was in obvious distress
with blood pressure of 90/50 mm Hg and a pulse rate of 80 - 70 beats per
minute. Abdominal ultrasound confirmed free fluid in the peritoneal cavity. Cesarean
section was performed on the lower segment of the uterus. A live premature
female infant was born weighing 2580 g, height 48 cm, and with an Apgar score
of 7 - 8 points. Then the integrity of the uterus was restored. Abdominal
rehabilitation was performed, there were about 1000 ml of blood loss and
continuous internal bleeding. Doctors found splenic ruptures around the
perineum. Lower middle laparotomy, splenectomy, abdominal rehabilitation,
drainage were performed. Conclusion: This case illustrates the need to
consider ruptured spleen as part of differential diagnosis of hemoperitoneum in
pregnant women. Immediate surgical intervention is needed to ensure survival of
mother and fetus.