目的

分析妊娠合并自发性脾破裂患者的临床表现、诊治过程、母儿预后，探讨治疗经验。

方法

回顾性分析2018年1月至2023年12月在我院常规产前检查的5例妊娠合并自发性脾破裂患者的临床资料，对患者的年龄、脾破裂发生时孕周、胎产次、既往病史、妊娠合并症、既往分娩方式、有无基础疾病、临床表现、辅助检查结果、治疗过程和预后等临床特点进行分析。

结果

脾破裂均发生于妊娠中、晚期，以突发腹痛为主要症状，很快出现不同程度的休克。5例患者均急诊行脾切除治疗，术后恢复良好。脾切除同时行剖宫产4例，其中1例胎儿宫内死亡；单纯行脾切除1例，胎儿妊娠足月后剖宫产娩出。

结论

妊娠合并自发性脾破裂容易误诊，有腹腔手术史的妊娠中、晚期孕妇，因急腹症就诊者需考虑自发性脾破裂的可能。及时抗休克治疗的同时，剖腹探查并切除脾脏，可避免母儿不良预后的发生。

Objective

To analyze the clinical manifestations，diagnosis and treatment process，maternal and fetal prognosis of spontaneous splenic rupture in pregnancy，and to summarize treatment experience.

Methods

A retrospective analysis was conducted on 5 pregnant patients with spontaneous splenic rupture who were registered and underwent routine prenatal examinations in our hospital from January 2018 to December 2023.Clinical parameters recorded and analyzed included：maternal age，gestational age at the time of splenic rupture，parity，medical history，pregnancy complications，previous delivery mode，presence of underlying diseases，clinical manifestations and auxiliary examination results，treatment process，and prognosis，respectively.

Results

Splenic rupture occurs in the second and third trimester of pregnancy，with sudden abdominal pain as the main symptom，and soon leading to varying degrees of shock.All 5 patients underwent emergency splenectomy and recovered well after surgery.Four cases underwent splenectomy and cesarean section simultaneously，of which one fetus died in the uterus.One case underwent simple splenectomy，and the fetus was delivered by cesarean section after full term pregnancy.

Conclusions

Spontaneous splenic rupture of pregnancy is prone to misdiagnosis.Pregnant women with a history of abdominal surgery in the second and third trimester of pregnancy exhibiting acute abdomen are demanded to consider the possibility of spontaneous splenic rupture.Treating shock promptly while exploring laparotomy urgently and splenectomy are performed to avoid maternal and fetal adverse prognosis.