Splenic artery aneurysmal rupture at 24 weeks gestation in a patient with successful in vitro fertilization and embryo transfer after kidney transplantation: a case report

Abstract Background Kidney transplantation represents a critical intervention for end-stage renal disease on a global scale. Many women of childbearing age who have received a kidney transplant express a significant desire to conceive. Nevertheless, the occurrence of in vitro fertilization-embryo tr...

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Main Authors: Wenbo Qiao, Xinyue Xiang, Junqing Chu, Yan Lin, Yayu Ren, Feifei Zhou, Chunhua Gao
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Nephrology
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Online Access:https://doi.org/10.1186/s12882-025-04285-y
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author Wenbo Qiao
Xinyue Xiang
Junqing Chu
Yan Lin
Yayu Ren
Feifei Zhou
Chunhua Gao
author_facet Wenbo Qiao
Xinyue Xiang
Junqing Chu
Yan Lin
Yayu Ren
Feifei Zhou
Chunhua Gao
author_sort Wenbo Qiao
collection DOAJ
description Abstract Background Kidney transplantation represents a critical intervention for end-stage renal disease on a global scale. Many women of childbearing age who have received a kidney transplant express a significant desire to conceive. Nevertheless, the occurrence of in vitro fertilization-embryo transfer (IVF-ET) following kidney transplantation remains infrequent. Case presentation A 32-year-old woman, who had undergone kidney transplantation nine years prior and IVF-ET six months ago, presented with abdominal pain. During her hospital stay, she suddenly experienced severe abdominal and chest pain. An abdominal CT angiography revealed a ruptured splenic artery aneurysm with pseudoaneurysm formation, necessitating an emergency exploratory laparotomy and subsequent splenic artery aneurysmectomy. Following the surgery, the patient was transferred to the intensive care unit (ICU) for hemodynamic stabilization, continuous monitoring of fetal heart rate and movement, adjustment of her immunosuppressive regimen, and targeted health education including personalized guidance on immunosuppressive drug management, recognition of pregnancy complications, and fetal monitoring. On the third day in the ICU, with her vital signs stabilized, the patient was transferred to the obstetric ward for further management. In the end, She was successfully maintained until 36 weeks of gestation and delivered a healthy neonate via cesarean section without complications. Conclusion This case report presents the occurrence and management of a splenic artery rupture at 24 weeks of gestation following IVF-ET after kidney transplantation. This case highlights the critical role of multidisciplinary management, individualized fetal monitoring, and optimized immunosuppressive therapy in addressing life-threatening vascular complications in pregnant kidney transplant recipients, providing a valuable reference for similar clinical scenarios. Clinical trial number Not applicable.
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spelling doaj-art-5bceaa13614f4d20b97f14f335d6db3f2025-08-20T03:03:29ZengBMCBMC Nephrology1471-23692025-07-012611510.1186/s12882-025-04285-ySplenic artery aneurysmal rupture at 24 weeks gestation in a patient with successful in vitro fertilization and embryo transfer after kidney transplantation: a case reportWenbo Qiao0Xinyue Xiang1Junqing Chu2Yan Lin3Yayu Ren4Feifei Zhou5Chunhua Gao6Department of Nursing, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Respiratory Medicine, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of General Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of General Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of General Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of General Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Nursing, The First Affiliated Hospital, Zhejiang University School of MedicineAbstract Background Kidney transplantation represents a critical intervention for end-stage renal disease on a global scale. Many women of childbearing age who have received a kidney transplant express a significant desire to conceive. Nevertheless, the occurrence of in vitro fertilization-embryo transfer (IVF-ET) following kidney transplantation remains infrequent. Case presentation A 32-year-old woman, who had undergone kidney transplantation nine years prior and IVF-ET six months ago, presented with abdominal pain. During her hospital stay, she suddenly experienced severe abdominal and chest pain. An abdominal CT angiography revealed a ruptured splenic artery aneurysm with pseudoaneurysm formation, necessitating an emergency exploratory laparotomy and subsequent splenic artery aneurysmectomy. Following the surgery, the patient was transferred to the intensive care unit (ICU) for hemodynamic stabilization, continuous monitoring of fetal heart rate and movement, adjustment of her immunosuppressive regimen, and targeted health education including personalized guidance on immunosuppressive drug management, recognition of pregnancy complications, and fetal monitoring. On the third day in the ICU, with her vital signs stabilized, the patient was transferred to the obstetric ward for further management. In the end, She was successfully maintained until 36 weeks of gestation and delivered a healthy neonate via cesarean section without complications. Conclusion This case report presents the occurrence and management of a splenic artery rupture at 24 weeks of gestation following IVF-ET after kidney transplantation. This case highlights the critical role of multidisciplinary management, individualized fetal monitoring, and optimized immunosuppressive therapy in addressing life-threatening vascular complications in pregnant kidney transplant recipients, providing a valuable reference for similar clinical scenarios. Clinical trial number Not applicable.https://doi.org/10.1186/s12882-025-04285-yPost-kidney transplantationIn vitro fertilization-embryo transferSplenic artery ruptureNursing
spellingShingle Wenbo Qiao
Xinyue Xiang
Junqing Chu
Yan Lin
Yayu Ren
Feifei Zhou
Chunhua Gao
Splenic artery aneurysmal rupture at 24 weeks gestation in a patient with successful in vitro fertilization and embryo transfer after kidney transplantation: a case report
BMC Nephrology
Post-kidney transplantation
In vitro fertilization-embryo transfer
Splenic artery rupture
Nursing
title Splenic artery aneurysmal rupture at 24 weeks gestation in a patient with successful in vitro fertilization and embryo transfer after kidney transplantation: a case report
title_full Splenic artery aneurysmal rupture at 24 weeks gestation in a patient with successful in vitro fertilization and embryo transfer after kidney transplantation: a case report
title_fullStr Splenic artery aneurysmal rupture at 24 weeks gestation in a patient with successful in vitro fertilization and embryo transfer after kidney transplantation: a case report
title_full_unstemmed Splenic artery aneurysmal rupture at 24 weeks gestation in a patient with successful in vitro fertilization and embryo transfer after kidney transplantation: a case report
title_short Splenic artery aneurysmal rupture at 24 weeks gestation in a patient with successful in vitro fertilization and embryo transfer after kidney transplantation: a case report
title_sort splenic artery aneurysmal rupture at 24 weeks gestation in a patient with successful in vitro fertilization and embryo transfer after kidney transplantation a case report
topic Post-kidney transplantation
In vitro fertilization-embryo transfer
Splenic artery rupture
Nursing
url https://doi.org/10.1186/s12882-025-04285-y
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