Dr Zala Skrbis, Dr Penny Wolski, Dr Fiona Britten, Dr Ann-Maree Craven1
1Royal Brisbane and Womens Hospital, Brisbane, Australia
Biography:
Biographies to come
Abstract:
Portal hypertension with splenic artery aneurysms, while uncommon, is a serious and complex medical and surgical issue which requires close monitoring and expert medical and obstetric care in the pre-conception, gestation and post partum periods. Despite optimal management, there remains a significant risk of hepatic decompensation and bleeding varices, and a poorly quantified risk of rupture of splenic artery aneurysms during these high risk periods.
This case series analyses the outcome of five women with portal hypertension and splenic artery aneurysms in pregnancy recently managed by our tertiary obstetric medicine department. In this cohort, a number of complications were encountered including bleeding oesophageal varices, significant thrombocytopenia, abdominal varices and symptomatic splenomegaly. Treatment included splenectomy in pregnancy to treat splenic artery aneurysms in three of the five cases.
Analysis of this case series has highlighted the importance of preconception planning and medical optimization of women with known portal hypertension and preconception investigation and treatment of splenic artery aneurysms. Managing these patients in the context of a multidisciplinary team in a specialized tertiary centre is crucial in ensuring optimal maternal and fetal outcomes.
Keywords
Splenic Artery Aneurysm, portal hypertension, splenectomy