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Fulminant hepatitis A infection in second trimester of pregnancy requiring living‐donor liver transplantation
Author(s) -
Simsek Yavuz,
Isik Burak,
Karaer Abdullah,
Celik Onder,
Kutlu Ramazan,
Aydin Nasuhi Engin,
Yilmaz Sezai
Publication year - 2012
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.1447-0756.2011.01757.x
Subject(s) - medicine , pregnancy , fibrous capsule of glisson , fetus , liver transplantation , hepatic encephalopathy , liver function tests , obstetrics , hepatitis , liver function , surgery , fulminant hepatitis , transplantation , gastroenterology , cirrhosis , genetics , biology
Abstract We present an 18‐year‐old pregnant woman who was referred to our emergency clinic as a case of acute hepatic failure and hepatic encephalopathy. Laboratory tests showed abnormal liver function tests and serological workup was consistent with acute hepatitis A infection. Ultrasonography revealed a single live fetus with fetal biometry compatible with 18 gestational weeks. The patient underwent a highly urgent liver transplantation using a right lobe graft from her husband. Histological examination of the explanted liver showed acute, lymphocyte‐rich, diffuse necrotizing hepatitis, consistent with acute necrotizing hepatitis A. After the operation her allograft function gradually recovered. Her follow‐up obstetrics ultrasound revealed a male fetus with severely decreased amniotic fluid. The patient was informed about the poor prognosis of her pregnancy and the pregnancy was terminated by vaginal misoprostol induction. She has maintained a good general condition and liver function for 4 months postoperatively, up to the present time.