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妊娠合并巨大脾肿大和全血细胞减少:一例报告

Pregnancy With Massive Splenomegaly and Pancytopenia: A Case Report.

作者信息

Sengupta Rajasi K, Inamdar Saunitra A

机构信息

Obstetrics and Gynaecology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND.

出版信息

Cureus. 2023 Dec 17;15(12):e50656. doi: 10.7759/cureus.50656. eCollection 2023 Dec.

Abstract

Massive splenomegaly complicating pregnancy is a rare clinical entity that poses special difficulties, such as anemia, thrombocytopenia, ascites, and jaundice. This case report of a pregnant woman with large splenomegaly and pancytopenia highlights the value of prompt diagnosis and effective treatment. Splenomegaly can have a number of causes, including viral infections, hematological problems, portal hypertension, and metabolic abnormalities. A 29-year-old gravida 3 woman at 37 weeks of gestation who had massive splenomegaly was admitted and underwent a cesarean section to avoid complications of splenomegaly. The case report discusses the difficulties in obstetric management caused by enormous splenomegaly during pregnancy, including the choice of delivery method. Significant complications include splenic rupture and bleeding, particularly when pancytopenia is present. The need for several transfusions, the potential side effects of transfusion therapy, and factors related to the origin of splenomegaly when assessing maternal-fetal outcomes are discussed in this case report. The study concludes that in cases with pancytopenia splenomegaly during pregnancy, vigilant monitoring, prompt intervention, and a multidisciplinary approach are crucial to achieve positive outcomes for both the mother and the fetus.

摘要

妊娠合并巨大脾肿大是一种罕见的临床情况,会带来诸如贫血、血小板减少、腹水和黄疸等特殊难题。本病例报告讲述了一名患有巨大脾肿大和全血细胞减少症的孕妇,凸显了及时诊断和有效治疗的价值。脾肿大可能有多种原因,包括病毒感染、血液系统问题、门静脉高压和代谢异常。一名妊娠37周、怀有3胎的29岁女性因巨大脾肿大入院,并接受了剖宫产以避免脾肿大的并发症。该病例报告讨论了孕期巨大脾肿大给产科管理带来的困难,包括分娩方式的选择。严重并发症包括脾破裂和出血,尤其是在存在全血细胞减少症时。本病例报告讨论了评估母婴结局时多次输血的必要性、输血治疗的潜在副作用以及与脾肿大病因相关的因素。研究得出结论,对于孕期出现全血细胞减少性脾肿大的病例,密切监测、及时干预和多学科方法对于实现母婴良好结局至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0af3/10790516/f78cf636a0c8/cureus-0015-00000050656-i01.jpg

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