Although ruptured splenic artery aneurysm in pregnancy is frequently fatal for mother and infant, prompt diagnosis and surgical treatment increase their chances for survival. Normal physiologic and hemodynamic changes of pregnancy may mask early symptoms of hypovolemic shock in pregnant women. The fetus is especially at risk, because maternal compensatory mechanisms activated during hemorrhage shunt blood from uteroplacental circulation to maternal central circulation. Collaboration between perinatal and critical care team members is essential.

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