Pregnancy Outcome in 57 patients with Splenomegaly

Background: The spleen is a lymphopoietic organ, contains almost one quarter of the body’s lymphocytes, helps mediate both cellular and humoral immunity, and participates in immune responses against blood-borne pathogens. Method: This was a prospective cross sectional facility based study, carried out at Kassala hospital, Sudan between 1 of May 2019 to 30 of April 2020. The study sought to investigate the pregnancy outcome in women with splenomegaly, an enlarged spleen detected by palpation during the physical examination and subcategorized into mild, moderate and severe one according to its length below the left costal margin. Ultrasound was performed to help determine the size of the spleen. Means and proportions were compared between the groups of the study-using student and x test, and P<0.05 was considered significant. Results: During the study period, we approached 57 women with splenomegaly. The most predominant type of splenomegaly was massive (50.9%) splenomegaly. The reported obstetric complications among the investigated women include intrauterine growth restriction (19.3%), preterm labor ((17.5%), miscarriage (12.3%) and stillbirth (3.5%). Out of 50 patients their pregnancy progressed to delivery, two patients underwent cesarean delivery due to fetal distress and meconium stained liquor in early labor. Three patients developed primary hemorrhage requiring blood transfusion with ≥ 2 units of blood. Respiratory distress syndrome (RDS), acute tachypnea of the newborn and stillborn babies were observed in 18%, 6% and 4% respectively. Higher proportion of women with poor obstetric outcomes was observed in cases of massive splenomegaly in comparison with other types. Conclusion: The study showed significant association between adverse obstetric outcomes and massive splenomegaly.