Abstract
Aims: To highlight the importance of considering non-obstetrical etiologies for acute abdominal pain in gravid patients with risk factors for vasculopathies including diabetes and hypertension. Specifically, we report a tragic case of splenic artery aneurysm (SAA) rupture during the third trimester in a diabetic patient resulting in maternal-fetal mortality. Traumatic vascular events during pregnancy may be associated with a high rate of maternal and fetal morbidity or mortality. Therefore early and rapid intervention is critical to the obstetrical outcome. Presentation of Case: A 35 year old multiparous hypertensive diabetic patient presented with acute abdominal pain at 33 weeks of gestation. The presumptive diagnosis was concealed placental abruption with diabetic ketoacidosis. Although nonobstetrical diagnoses were not initially considered, postmortem analysis revealed a nonobstetrical etiology of SAA rupture with catastrophic consequences for the patient and fetus.
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