33-year-old mother loses baby due to liver damage

A pregnant woman, 26 weeks pregnant, was admitted to a maternity hospital with abdominal pain and an abnormally large abdomen. The fetus could not be saved due to acute fetal distress.

On June 23, the Central Hospital for Tropical Diseases announced that it had just received and treated a rare case of liver damage.

Patient TTT, 33 years old, in Bac Ninh , was transferred to the hospital after surgery for monitoring and to find the cause of liver damage.

Previously, a pregnant woman in her third pregnancy at 26 weeks of gestation was admitted to a maternity hospital with abdominal pain, an abnormally large abdomen, and prominent collateral circulation in the epigastric region. The patient was diagnosed with peritonitis and was scheduled for emergency surgery.

During the surgery, the doctors discovered an enlarged liver with a rough, dark surface and cloudy fluid in the abdomen. The fetus could not be saved due to acute fetal distress. After the surgery, the patient was transferred to the Central Hospital for Tropical Diseases for further treatment and to find the cause of the liver damage.

Here, the results of magnetic resonance imaging (MRI of the abdomen with contrast) showed an enlarged liver, fibrosis, and uneven contrast uptake in the veins; dilated hepatic veins, narrowing of the segment that drains into the inferior vena cava. The epigastric collateral circulation was clearly developed, the spleen was enlarged (143mm), the gallbladder wall was thick, and no large blood clots or free abdominal fluid were noted. The images suggested Budd-Chiari syndrome - a rare condition caused by obstruction of blood flow out of the liver, usually due to a blood clot (thrombus) that narrows or blocks the hepatic veins or inferior vena cava.

Doctor Nguyen Thi Thu Huyen - International Medical Examination and Treatment Center and on Demand (Central Hospital for Tropical Diseases) said that based on clinical and imaging progress, the patient was diagnosed with Budd-Chiari syndrome on the background of pregnancy, accompanied by severe complications such as increased portal vein pressure, ascites, peritonitis and acute fetal distress. Notably, this woman had two miscarriages of unknown cause. Doctors suspect that the patient has an underlying undetected blood clotting disorder.

According to Dr. Huyen, Budd-Chiari syndrome is a condition of obstruction of blood flow from the liver to the heart, usually due to blood clots in the hepatic veins or due to compression such as tumors and cysts. This is a rare but dangerous disease that can cause acute liver failure and be life-threatening if not diagnosed and treated promptly. During pregnancy, the disease can progress silently but the consequences are very serious.

About 80% of Budd-Chiari patients are associated with coagulation disorders such as myeloproliferative disorders, cancers (liver, kidney, adrenal gland, right atrium, etc.), benign tumors in the liver, abdominal aortic aneurysm, and especially pregnancy or use of oral contraceptives - accounting for up to 20% of cases. The possible cause is often found in Asia and South Africa is congenital structural abnormalities: including a web in the inferior vena cava, or other congenital abnormalities of the hepatic veins.

“During pregnancy, a woman’s body tends to increase blood clotting to prepare for childbirth. If a pregnant woman has a pre-existing blood clotting disorder that is not detected, the risk of thrombosis - especially in large blood vessels such as the hepatic vein - is entirely possible,” Dr. Huyen emphasized.

Dr. Huyen recommends that pregnant women with a history of consecutive miscarriages, unexplained stillbirths, early preeclampsia, or relatives with thrombosis should be screened for blood clotting disorders before and during pregnancy. Patients with signs such as rapidly enlarging abdomen, pain in the liver area, jaundice, leg swelling, or prolonged fatigue should go to the hospital for early examination. Treatment of Budd-Chiari syndrome requires the coordination of many specialties, including hepatobiliary, obstetrics, hematology, and diagnostic imaging, to ensure the safety of both mother and fetus./.

(Vietnam+)

Source: https://www.vietnamplus.vn/san-phu-33-tuoi-mat-con-vi-hau-qua-cua-ton-thuong-gan-post1045852.vnp