Splenomegaly, pancytopenia and pregnancy: a case report and review of the literature

Pregnancy With Massive Splenomegaly and Pancytopenia: A Case Report

Massive splenomegaly complicating pregnancy is a rare clinical entity that poses special difficulties, such as anemia, thrombocytopenia, ascites, and jaundice. This case report of a pregnant woman with large splenomegaly and pancytopenia highlights the value of prompt diagnosis and effective treatment. Splenomegaly can have a number of causes, including viral infections, hematological problems, portal hypertension, and metabolic abnormalities. A 29-year-old gravida 3 woman at 37 weeks of gestation who had massive splenomegaly was admitted and underwent a cesarean section to avoid complications of splenomegaly. The case report discusses the difficulties in obstetric management caused by enormous splenomegaly during pregnancy, including the choice of delivery method. Significant complications include splenic rupture and bleeding, particularly when pancytopenia is present. The need for several transfusions, the potential side effects of transfusion therapy, and factors related to the origin of splenomegaly when assessing maternal-fetal outcomes are discussed in this case report. The study concludes that in cases with pancytopenia splenomegaly during pregnancy, vigilant monitoring, prompt intervention, and a multidisciplinary approach are crucial to achieve positive outcomes for both the mother and the fetus.

Normal sonographic values of maternal spleen size throughout pregnancy

This study aims to establish normal range of sonographically measured maternal spleen size throughout pregnancy. Currently, 288 healthy pregnant women between 6 and 42 weeks' gestation underwent ultrasonographic measurements of spleen length and width. The relationships between ultrasound measurements with prepregnancy body mass index (BMI) and gestational age were assessed using the Pearson correlation coefficient. A linear regression model was applied to construct the appropriate equation for measuring the spleen area relative to BMI and gestational age. A significant correlation (R) was found between gestational age and spleen dimensions length (R = 0.486; p < 0.001), width (R = 0.455; p < 0.001) and area (R = 0.522; p < 0.001)) as well as between prepregnancy BMI and spleen length [(R = 0.314; p < 0.001), width (R = 0.380; p < 0.001) and area (R = 0.413; p < 0.001)]. We divided the spleen area by the BMI, thus enabling to perform a linear regression analysis with gestational age (weeks) as an independent continuous variable. A high multiple correlation (R) between spleen area and this variable was found (R(2) = 0.47; p < 0.001). The equation [spleen area/BMI = 1.598 + 0.032 x gestational age in weeks] was performed for calculating the spleen area throughout pregnancy. A significant overall growth pattern of spleen area in pregnancy with increasing gestational age was found. Normograms from these data can be used to evaluate splenomegaly throughout pregnancy.