Splenic rupture associated with severe preeclampsia. A case report.

BACKGROUND

Splenic rupture is a very rare event complicating pregnancy. Approximately 5% of cases reported have involved the postpartum period. Unrecognized, this complication is universally fatal.

CASE: Preeclampsia and pulmonary edema complicated a 42-year-old woman's intrapartum care. After cesarean delivery she was supported with mechanical ventilation, blood products and invasive monitoring. Shortly thereafter, she became hypotensive and developed disseminated intravascular coagulation. During exploratory laparotomy a splenic capsular rupture was identified. Splenectomy and continued intensive care support ultimately reversed the severe end-organ consequences.

CONCLUSION

It is extremely important that this condition be maintained in the diagnostic differential of post-operative hemodynamic instability. Failure to identify it is invariably fatal. Awareness and intervention are essential to ensure a good outcome.