Department of Obstetrics and Gynecology, Faculty of Medicine, Kassala University, Kassala, Sudan.
Alshuhada Teaching Hospital, Khartoum, Sudan.
BMC Pregnancy Childbirth. 2023 Mar 4;23(1):144. doi: 10.1186/s12884-023-05465-0.
The spleen is a lymphopoietic organ, contains almost one quarter of the body's lymphocytes.
This was a prospective cross sectional study, carried out at Kassala hospital, Sudan between 1st of May 2019 to 30th of April 2020. The objective of this study was to investigate the outcome of pregnancy in women with splenomegaly. A total coverage of 57 women with splenomegaly were approached among all pregnant women attending the hospital and asking for care. An enlarged spleen detected by palpation and subcategorized into mild, moderate and severe one according to its length below the left costal margin using Ultrasound. Data was collected using structured questionnaire. Means and proportions were compared between the groups of the study-using student and x test, and P < 0.05 was considered significant.
The most predominant type of splenomegaly was massive (50.9%) splenomegaly. The reported obstetric complications among the investigated women include: intrauterine growth restriction (19.3%), preterm labor ((17.5%), miscarriage (12.3%) and stillbirth (3.5%). Out of 50 patients their pregnancy progressed to delivery, three patients developed primary hemorrhage requiring blood transfusion with ≥ 2 units of blood. Respiratory distress syndrome (RDS), acute tachypnea of the newborn and stillborn babies were observed in 18%, 6% and 4% respectively. Higher proportion of women with poor obstetric outcomes was reported in cases of massive splenomegaly in comparison with other types.
The study showed significant association between adverse obstetric outcomes and massive splenomegaly. Thus, it is important to consider splenomegaly as one of the factors making the pregnancy high-risk one.
脾脏是一个淋巴造血器官，包含近四分之一的全身淋巴细胞。
这是一项在苏丹卡萨拉医院进行的前瞻性横断面研究，时间为 2019 年 5 月 1 日至 2020 年 4 月 30 日。本研究的目的是探讨脾肿大孕妇的妊娠结局。对所有在医院就诊并寻求治疗的孕妇进行了全面普查，共发现 57 例脾肿大孕妇。通过触诊发现肿大的脾脏，并根据脾脏长度在左肋缘下的位置分为轻度、中度和重度，通过超声进行分类。使用结构化问卷收集数据。使用学生 t 检验和卡方检验比较研究组之间的均值和比例，P 值<0.05 被认为具有统计学意义。
最常见的脾肿大类型为巨脾（50.9%）。在所调查的女性中，报告的产科并发症包括：宫内生长受限（19.3%）、早产（17.5%）、流产（12.3%）和死产（3.5%）。在 50 名进展至分娩的患者中，有 3 名患者因原发性出血需要输注≥2 单位的血液。呼吸窘迫综合征（RDS）、新生儿急性呼吸急促和死产婴儿的发生率分别为 18%、6%和 4%。与其他类型相比，巨脾病例中报告的不良产科结局比例更高。
本研究表明，不良产科结局与巨脾之间存在显著关联。因此，将脾肿大视为使妊娠成为高危妊娠的因素之一非常重要。
