Successful pregnancy following orthotopic liver transplantation for idiopathic Budd-Chiari syndrome

The Journal of Maternal-fetal Medicine
P S RamseyK D Ramin

Abstract

Budd-Chiari syndrome is a rare and serious thrombotic event with significant morbidity and mortality. Recommendations regarding future conception and management during pregnancy have not been defined. We present a patient with history of idiopathic Budd-Chiari Syndrome and subsequent orthotopic liver transplantation who was successfully managed during pregnancy. A 24-year-old white female, gravida 1 para 0, status postorthotopic liver transplantation 5 years previously for Budd-Chiari syndrome with post-transplant insulin-dependent diabetes mellitus presented to our clinic at 7 weeks of gestation for initial prenatal evaluation. Maintenance immunosuppressive therapy and prophylactic heparin anticoagulation was administered throughout the pregnancy, which was uneventful until 35 weeks gestation, at which time pre-eclampsia and premature preterm rupture of membranes prompted labor induction. The patient developed no evidence of acute or chronic hepatic rejection and no evidence of recurrent Budd-Chiari syndrome during the pregnancy or post-partum convalescence. Prudent use of prophylactic anticoagulation, close immunosuppressive monitoring, and periodic fetal and maternal surveillance are warranted in patients with previous ortho...Continue Reading

Citations

Oct 17, 2013·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·A AnbazhaganN McDougall
Oct 9, 2008·The Journal of Obstetrics and Gynaecology Research·Sasaki HiroeChiaki Ban
Mar 15, 2003·Gastroenterology Clinics of North America·Mitchell S Cappell, David Friedel
May 16, 2009·Journal of Hepatology·Pierre-Emmanuel RautouAurélie Plessier
Jun 4, 2016·Medicine·Waltraut M MerzJonel Trebicka

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