Departments of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Zerifin, 70300, Israel.
Departments of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Zerifin, 70300, Israel.
Eur J Obstet Gynecol Reprod Biol. 2019 Jun;237:121-125. doi: 10.1016/j.ejogrb.2019.04.029. Epub 2019 Apr 19.
In this study we report our experience in the management of Splenic Artery Aneurysm (SAA), diagnosed during pregnancy.
The current manuscript describes three different events, treated in out our department, involving SAAs diagnosed during pregnancy. Each case presents an unusual course and a unique clinical challenge.
The first case is of a 25 week's gestation twin pregnancy with ruptured SAA ending in maternal and fetal death. Another case of SAA rupture presented at 27 week's gestation with consequent emergency cesarean section and splenectomy. In the last case, two SAAs were incidentally diagnosed at 25 weeks' singleton gestation. The patient was managed conservatively and delivered by an elective cesarean section at 34 weeks followed by postpartum angiographic embolization of the aneurysms.
Health care providers and especially obstetricians should be aware of the diagnosis of ruptured SAA in a pregnant woman with abdominal discomfort and hemodynamic deterioration. In addition, once an asymptomatic pregnant patient is diagnosed with a SAA, conservative surveillance may be allowed.
本研究报告了我们在妊娠期间诊断出的脾动脉瘤（SAA）治疗方面的经验。
本手稿描述了我们科室治疗的三例不同的事件，涉及妊娠期间诊断出的 SAA。每个病例都呈现出不同寻常的病程和独特的临床挑战。
第一个病例是 25 周妊娠的双胞胎，伴有破裂的 SAA，导致母亲和胎儿死亡。另一个 SAA 破裂病例发生在 27 周妊娠，随后进行紧急剖宫产和脾切除术。最后一个病例，在 25 周妊娠的单胎中偶然诊断出两个 SAA。患者接受保守治疗，34 周时行择期剖宫产，产后行动脉瘤血管内栓塞治疗。
医护人员，尤其是产科医生，应该意识到在孕妇出现腹部不适和血流动力学恶化时诊断出破裂的 SAA。此外，一旦无症状的妊娠患者被诊断出 SAA，可以允许进行保守监测。
