Rupture of maternal splenic artery aneurysm and fetal demise

Splenic artery aneurysm (SAA) is the third most common intra-abdominal aneurysm. This condition, which occurs predominantly in young women, is generally asymptomatic and frequently discovered during pregnancy upon rupture. Reported maternal and fetal mortality are respectively 75% and 72.5-95%. A 40-year-old woman gravida 4 para 3 was referred to the obstetrical emergencies at term for loss of consciousness, nausea, vomiting, and hypotension. At admission, the patient had developed upper abdominal pain. Fetal demise and hemoperitoneum were diagnosed. An abdominal computed tomography (CT) scan revealed SAA rupture. An emergency hemostatic splenectomy was performed followed by a cesarean section with a favorable subsequent outcome. SAA rupture should be considered in the differential diagnosis of acute abdominal pain during pregnancy. Prompt multidisciplinary management is essential for patient's survival.