Spontaneous splenic rupture associated with postpartum preeclampsia following cesarean delivery in a twin pregnancy, complicated by post-splenectomy hemorrhage: a case report

Spontaneous splenic rupture is a rare occurrence during pregnancy and the puerperium, but it can be life-threatening for both mother and fetus, especially if diagnosis is delayed. The patient was a 42-year-old primigravida with a twin pregnancy, conceived after two years of infertility. She experienced spotting at 10 weeks and underwent cerclage at 22 weeks. At 37 weeks and 3 days, following the rupture of membranes, she delivered via cesarean section. Four days postpartum, she was hospitalized for three days with symptoms of preeclampsia. Ten days after the cesarean section, an exploratory laparotomy was performed due to suspected intra-abdominal bleeding, and a splenectomy was carried out to address a splenic rupture. Approximately one day later, a repeat laparotomy was necessary due to postoperative bleeding. After 11 days in the hospital, the patient was discharged in stable condition. In the three years following the splenectomy, she did not report any specific issues. This case underscores the importance of vigilant monitoring of maternal health following delivery, particularly in high-risk pregnancies. All postpartum complaints should be thoroughly evaluated and addressed. Furthermore, patients who undergo splenectomy should be routinely monitored to identify and manage any complications.