Abstract

Background: Pregnancy with massive splenomegaly is a rare entity and is associated with increased risk to both mother and fetus. There is paucity of studies in the literature to guide clinicians for the management of this condition.
Materials and Methods: We reviewed the course of pregnancy, maternal and fetal outcomes of 6 pregnant women with massive splenomegaly who were managed in our unit during 2019-2021.
Results: We reviewed the course and outcome of 6 pregnant women with massive splenomegaly {>17cm}. Patients characteristics including age, history (fever, thrombotic episodes, gastrointestinal haemorrhage), and treatment history were recorded. Laboratory investigations (complete blood counts, liver function tests and viral markers); ultrasonography with colour Doppler (to assess the echotexture of the liver, and measure the spleen size, liver span and diameter of the portal vein), upper gastrointestinal (GI) endoscopy; autoimmune work-up (lupus anticoagulant and antiphospholipid antibody) and peripheral smear for malaria parasite was done as indicated. The course of pregnancy, mode of delivery, and maternal and fetal outcome were noted.
Conclusion: Pregnancy with massive splenomegaly poses a challenge because of diverse etiology and potentially adverse outcomes. Multidisciplinary care in a tertiary center can help optimize the outcome