[Splenic arterial aneurysm and pregnancy: A review]

Abstract

The aneurysm of the splenic artery (SAA) is rare. His rupture is one cause of non-obstetrical hemoperitoneum and abdominal pain during pregnancy. The increased splanchnic and splenic arterial blood flow due to pregnant uterus by compression of the aorta and iliac vessels, and alterations of the arterial wall structures, induced by hormonal modifications, are thought to be the principal factor in SAA development and rupture. The emergency splenectomy during pregnancy has been reported in over 100patients in the literature and appears to be associated with a maternal mortality rate around 75% and a fetal mortality rate around 95%. According to literature review, adequate surgical treatment and a multidisciplinary approach including surgeons and obstetricians is needed to lead to a decrease in the rates of maternal and fetal mortality in cases of SAA. The midline laparotomy seems to improve materno-fetal prognosis. Therefore, physicians should be aware of ruptured SAA in case of hemoperitoneum in pregnant woman. When the pathology is suspected, prompt diagnosis, immediate resuscitation and surgical management of rupture of SAA in an appropriate structure are needed to ensure survival of both mother and fetus.