title: Acute Budd-Chiari syndrome during pregnancy: surgical treatment and orthotopic liver transplantation with successful completion of the pregnancy.
abstract: A 26-year-old woman presented with acute Budd-Chiari syndrome 18 weeks into a pregnancy. She was found to be heterozygous for the G20210A prothrombin gene mutation. She was treated with portacaval shunt placement and successfully completed the pregnancy, with a healthy baby delivered at 31 weeks' gestation. She developed progressive liver failure after delivery of the child, likely associated with clotting of the shunt, which occurred in the face of full anticoagulation. The patient subsequently underwent a technically complicated orthotopic liver transplantation, but died 10 months after transplantation. This case illustrates the challenges involved in the treatment of Budd-Chiari syndrome, in addition to difficulties balancing the health of a mother and an unborn child. It is the only case of surgical treatment of Budd-Chiari syndrome during pregnancy reported in the literature.
authors.affiliation: Organ Transplantation Program, University of Nebraska Medical Center, Omaha, NE 68198, USA. wgrant@surgery.unmc.edu
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Grant
authors.forename: Timothy
authors.initials: T
authors.lastname: McCashland
authors.forename: Jean F
authors.initials: JF
authors.lastname: Botha
authors.forename: Byers W
authors.initials: BW
authors.lastname: Shaw
authors.forename: Debra L
authors.initials: DL
authors.lastname: Sudan
authors.forename: Alejandro
authors.initials: A
authors.lastname: Mejia
authors.forename: Kishore
authors.initials: K
authors.lastname: Iyer
authors.forename: Alan N
authors.initials: AN
authors.lastname: Langnas
mesh_terms: D000208:Acute Disease; D000328:Adult; D006502:Budd-Chiari Syndrome / Q000601:surgery*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D016031:Liver Transplantation; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome