Management of splenic artery aneurysm rupture during trial of scar with epidural analgesia,

We report a case of ruptured splenic artery aneurysm during labor in which the clinical signs were masked by epidural analgesia. A high index of clinical suspicion must be maintained in cases of atypical epidural breakthrough pain, and attending clinicians must be prepared for the unexpected when faced with a maternal collapse. (Am J Obstet Gynecol 1999;180:1038-9.)