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Case of Budd–Chiari syndrome 3 months after vaginal delivery
Author(s) -
Hiroe Sasaki,
Itoh Hiroaki,
Matsumoto Hisanori,
Takahasi Syhugen,
Sato Yukiyasu,
Yamada Shigetoshi,
Okagaki Atsuhiko,
Kuzushita Noriyoshi,
Ban Chiaki
Publication year - 2008
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2008.00893.x
Subject(s) - medicine , budd–chiari syndrome , ascites , inferior vena cava , vaginal delivery , surgery , abdominal pain , spironolactone , furosemide , heart failure , pregnancy , biology , genetics
Budd–Chiari syndrome is a rather unusual clinical situation caused by occlusion of the hepatic vein of inferior vena cava, the classical triad of which are abdominal pain, ascites and hepatomegaly. A 29‐year‐old gravida 3 para 1 woman delivered an immature male baby weighing 2172 g with an Apgar score of 9 points at 35 weeks and 3 days of gestation. She was transferred to the National Hospital Organization Osaka National Hospital 112 days after delivery due to the sudden development of massive ascites. Magnetic resonance angiography and enhanced computed tomography detected the occlusion by thrombosis of both the middle and left hepatic veins, so she was diagnosed with Budd–Chiari syndrome. Her protein C antigen and activity were 37% and 50%, respectively, corresponding to type 1 protein C deficiency. Conservative treatment by continuous oral treatment of spironolactone (25 mg/day), furosemide (20 mg/day) and prophylactic warfarin (2 mg/day) much improved the ascites.