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Federación Mexicana de Ginecología y Obstetricia, A.C.

2017, Number 09

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Ginecol Obstet Mex 2017; 85 (09)

Splenic rupture in the puerperium associated with preeclampsia

López-Flores AA, Hernández-Higareda S, Rodríguez-Gómez KE, Zamora-Amezcua A, López-Flores EU, Flores-Cruz J, Ramos-Santillan JE

Language: Spanish
References: 13
Page: 647-650
PDF size: 296.33 Kb.


ABSTRACT

Background: Splenic rupture is a very rare complication of pregnancy and puerperium, with extremely high maternal and fetal mortality. Maternal mortality reaches about 75% and fetal mortality up to 95%, complicating more frequently during the third trimester (69%) and rarely in the puerperium
Clinical case: We present the case of a 37-year-old female patient with a 31.1-week pregnancy who was referred to our hospital for preeclampsia with severity data with biochemical alterations and difficult control of blood pressure figures. In the immediate postoperative period, the patient develops acute abdominal pain with free fluid in the abdominal ultrasound. This procedure is followed by an emergency laparotomy, with a lesion of approximately 3 cm in the lower pole and splenic hilum performing emergency splenectomy. The postoperative period was uneventful and the patient was discharged 8 days after surgery.
Conclusions: The diagnosis and timely management of splenic rupture in the puerperium associated with Preeclampsia prevents maternal death.


REFERENCES

  1. Hamedi B, Shomali Z. Postpartum Spontaneous Rupture of Spleen in a Woman with Severe Preeclampsia: Case Report and Review of the Literature. Bull Emerg Trauma. 2013; 1(1):46-48.

  2. Antonio-Sanz E, Hernández-Gutiérrez N, Shahin M, Bartulos AV. Causas atraumáticas de rotura esplénica. SERAM 2012.

  3. Suárez-Torres I, Reyna-Villasmil E. Rotura espontánea del aneurisma de la arteria esplénica durante el embarazo. Clínica e Investigación en Ginecología y Obstetricia 2017;44(1): 35-37.

  4. Reyna-Villasmil E, Sabatini-Sáez I, Santos-Bolívar J, Perozo- Romero J, Peña-Paredes E. Rotura esplénica posparto asociada con preeclampsia. Cir Esp. 2008;84(4):227-36.

  5. Barrilleaux PS, Adair D, Johnson G, Lewis D. Splenic rupture associated with severe preeclampsia: a case report. J Reprod Med 1999; 44: 899-901.

  6. Lembet A, Saphier CJ, Gaddipati S, Divino C, Berkowitz RL. Post splenectomy splenic artery aneurysm rupture in an atypical presentation of pre-eclampsia. The Journal of Maternal-Fetal Medicine 2001;10:360-362.

  7. Ducassé JL, Fourcade O. Rupture of splenic artery aneurysm during early pregnancy: a rare and catastrophic event. American Journal of Emergency Medicine 2009;27:898.e5–898.e6.

  8. Shamsi U, Saleem S, Nishter N, Ameen AL. Epidemiology and risk factors of preeclampsia; an overview of observational studies. J Med Sci 2013; 6(4):292-300.

  9. Perucca PE y col. Rotura de un aneurisma esplénico durante el embarazo: a propósito de 2 casos clínicos. Rev Chil Obstet Ginecol 2006;71(1): 43-46.

  10. Laiz D, Rojas VH, Gana HJ, Aguirre C. Rotura de aneurisma de arteria esplénica durante el embarazo. Rev. Obstet. Ginecol. 2007;2(3):231-233.

  11. González-Martínez G, Aguirre-Suárez J, Alarcón-Sandoval A, Pulgar-Lehr A, Valbuena-Adrianza O. Ruptura hepática y esplénica asociada con preeclampsia severa: presentación de un caso. Invest. Clín 2004;45(1).

  12. Jacobson J, et al. Splenic artery aneurysm rupture in pregnancy. American Journal of Emergency Medicine 2016. DOI: http://dx.doi.org/10.1016/j.ajem.2016.12.035.

  13. Nanez L, Knowles M, Modrall JG, James VR. Ruptured splenic artery aneurysm are exceedingly rare in pregnant women. J Vasc Surg 2014;60:1520-1523.




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