Patient Diagnosed of Budd-Chiari Willing to Get Pregnant: Presentation of a New Case of Full-Term Pregnancy

Abstract

Budd-Chiari syndrome is an infrequent pathology characterized by the obstruction of the suprahepatic venous outflow. It can manifest in several ways and may become very severe. So far, there is great controversy on the issue of whether these patients should become pregnant, because of the complications this implies in this disease. Nowadays, there are very few cases of full-term pregnancy with good outcome reported. We present a case of a 36-year-old patient with subseptate uterus diagnosed of Budd-Chiari with Polycythemia Vera (jack2 gene mutation and heterozygosity for factor V Leiden). After being treated and the disease controlled, the patient got pregnant. This is one of the few cases that exist with good outcome. Strict follow-up of the patient was carried out at our hospital and no complications occurred throughout pregnancy and postpartum. The patient was treated prior to pregnancy with low molecular weight heparin and antiplatelet drugs until 24 hours prior to labor. Delivery occurred by cesarean section (CS) at 37 weeks without complications. The healthy newborn was discharged with the mother after one week of hospitalization. The proper control of this disease prior to pregnancy, together with strict monitoring conducted during it seems one of the keys to make possible pregnancy in young patients willing to get pregnant. In conclusion, this case could not support the contraindication of pregnancy in certain cases of this pathology. Moreover, the patient should be always informed of all the existing risks and complications.




doi: http://dx.doi.org/10.4021/jcgo148w