Laparoscopic Splenectomy for Resistant Immune Thrombocytopenia in Pregnancy- A Case Report and Review of Literature

Background: Thrombocytopenias in pregnancy are the second most common hematological disorder in pregnancy after anemia. About 7-10 percent of women experience this during pregnancy and most are due to gestational thrombocytopenia. About 3-4% are due to autoimmune process and is normally a diagnosis of exclusion. The management of this condition is mainly medical with splenectomy reserved only for very resistant cases. There is very limited literature on safety of laparoscopic splenectomy during pregnancy. We present such a case and a review of all cases of laparoscopic splenectomy in the literature. Case Report: A primigravid woman presented with resistant Immune thrombocytopenia during early pregnancy. She had very little response to all the medical treatments that are offered in pregnancy. She then had an uncomplicated laparoscopic splenectomy with good response during pregnancy. There was good maternal and neonatal outcome. Conclusion: Laparoscopic splenectomy can be safely considered for resistant cases of splenectomy during pregnancy. Key Words: Immune Thrombocytopenia; Pregnancy; Laparoscopy; Splenectomy; Safet