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      Ruptured splenic artery aneurysm in pregnancy. Twelfth reported case with maternal and fetal survival.

      American Journal of Obstetrics and Gynecology

      Adult, Aneurysm, mortality, surgery, Cesarean Section, Female, Fetal Death, Humans, Maternal Mortality, Pregnancy, Pregnancy Complications, Cardiovascular, Rupture, Spontaneous, Splenic Artery, Survival Analysis

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          Ruptured splenic artery aneurysm during pregnancy is a rare event with catastrophic consequences. This presentation is the twelfth case during pregnancy reporting survival of both mother and fetus. The literature reports a 25% mortality rate for ruptured splenic artery aneurysm. The mortality rate among pregnant women is disproportionately high at 75% with a fetal mortality rate of 95%. Gestational alterations that increase with parity are significant in the pathophysiologic characteristics of this condition. A unique double-rupture phenomenon may provide temporary tamponade with resolution of symptoms. A diagnosis of ruptured splenic artery aneurysm should be considered in any pregnant patient who complains of the sudden onset of severe left upper-abdominal pain regardless of whether pain or shock is prominent at the time of evaluation. Early consideration of a diagnosis of ruptured splenic artery aneurysm significantly increases the likelihood that the mother and fetus will survive.

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