Splenic Rupture During Pregnancy: A Misdiagnosed, Rare Obstetrical Emergency

Abstract

Splenic rupture in pregnancy is a rare entity, and the exact ethology is not very clear. Splenic rupture during pregnancy can be due to trauma or spontaneous due to other non-traumatic causes like hemophilias, leukaemia, kalazaar, splenic artery aneurysm, etc. Patients usually present in 3rd trimester and are frequently misdiagnosed as a case of placental abruption or uterine rupture. It leads to hypovolumic shock and increases maternal and fetal morbidity and mortality. Here, we have presented 3 cases of spontaneous splenic rupture and injury without any antecedent history in the first case, after a fall in 2nd case, and associated with kalazaar in 3rd case. Two patients were managed conservatively and had uneventful postoperative period, while splenectomy was done in one case, and feto-maternal mortality was seen in the same. The first two cases were preoperatively misdiagnosed as uterine rupture, and 3rd case was postoperatively diagnosed as Kalazaar. There is a need to enhance the knowledge of this rare condition in pregnancy as it is usually misdiagnosed and lethal for both mother and foetus.