Salvage Intrapartum Splenectomy for the Treatment of Transfusion-refractory Anaemia in a ß-thalassemia Intermedia Patient.

J Coll Physicians Surg Pak

Department of Internal Medicine, Faculty of Medicine, Division of Hematology, Istanbul University, Istanbul, Turkey.

Published: October 2022

Thalassemia intermedia (TI) patients may need a transfusion during physiological stress conditions, such as pregnancy. We present a case of a female TI patient with emerging transfusion-refractory anaemia during pregnancy, which resolved after splenectomy performed simultaneously with cesarean delivery. A 26-year pregnant woman at 29th gestational weeks was referred with a diagnosis of TI due to emerging anaemia which was refractory to transfusion. Splenectomy at term was decided to improve anaemia, and transfusion response. A preterm infant was delivered by cesarean section due to threatened preterm labour. Once the uterine incision was closed, an open splenectomy was performed. Postoperative follow-up was uneventful. To the best of our knowledge, the present case is the first open splenectomy performed during cesarean delivery as a salvage option for the management of transfusion-refractory anaemia. Key Words: Thalassemia intermedia, Splenectomy, Pregnancy, Hemolytic anaemia.

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http://dx.doi.org/10.29271/jcpsp.2022.10.1344DOI Listing

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