[Twin pregnancy after liver transplantation].
Orthotopic liver transplantation was performed in a 29-year-old woman because of increasing decompensation of HBs-antigen positive post-hepatitic cirrhosis. Postoperatively she developed a mild rejection reaction and diabetes mellitus. Thirteen months after the transplant she conceived twins. This high risk pregnancy was complicated by a febrile viral infection with purulent tracheobronchitis at 9 weeks and a threatened abortion at 11 weeks. At 33 weeks there was a sudden drop in haemoglobin due to a minor uterine rupture which necessitated cesarean section. The female infants--of development in keeping with the dates--showed no clinical or ultrasound evidence of any malformations. Apart from initial difficulties--asphyxia (second twin), fluctuating glucose and calcium levels, an episode of neonatal jaundice which required phototherapy, reluctance to suck and hypotonia--the further development of both twins proceeded normally. The maternal diabetes disappeared after delivery, HBs-antigen remained negative and the HBs-antibody titre rose. The patient has remained in good condition, both mentally and physically.
Kreuzpaintner
G
G
Medizinische Klinik D der Universität Düsseldorf.
Ringe
B
B
Niesert
S
S
Pichlmayr
R
R
Strohmeyer
G
G
D000033:Abortion, Threatened; D000328:Adult; D002585:Cesarean Section; D005260:Female; D006509:Hepatitis B / Q000150:complications; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology; D008103:Liver Cirrhosis / Q000209:etiology / Q000601:surgery; D016031:Liver Transplantation; D011247:Pregnancy; D011248:Pregnancy Complications; D011251:Pregnancy Complications, Infectious; D011272:Pregnancy, Multiple; D014597:Uterine Rupture
Zwillingsschwangerschaft nach Lebertransplantation.