On 24/6, the National Hospital of Tropical Diseases reported a 33-year-old pregnant woman who presented at a specialized obstetrics hospital with unusual rapid abdominal swelling, pain, and prominent superficial veins in the epigastric region.
Doctors diagnosed peritonitis and performed emergency surgery. During the procedure, the surgical team found an enlarged liver with a rough, dark surface and cloudy fluid in the abdominal cavity. The fetus could not be saved due to acute fetal distress.
Following the surgery, the patient was transferred to the National Hospital of Tropical Diseases for treatment and to determine the cause of the liver damage.
An abdominal MRI revealed an enlarged, fibrotic liver with uneven contrast uptake and dilated hepatic veins. The imaging suggested Budd-Chiari syndrome, a rare condition caused by blocked blood flow from the liver, typically due to a blood clot narrowing or obstructing the hepatic veins or inferior vena cava.
Dr. Nguyen Thi Thu Huyen from the hospital's International and On-Demand Healthcare Center confirmed the diagnosis of Budd-Chiari syndrome during pregnancy, complicated by portal hypertension, ascites, peritonitis, and acute fetal distress. The woman had experienced two previous miscarriages of unknown cause. Doctors suspect she may have an underlying, undiagnosed blood clotting disorder.
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A doctor examines the patient. Photo: Hospital provided |
A doctor examines the patient. Photo: Hospital provided
Budd-Chiari syndrome is a dangerous condition that can cause acute liver failure and be life-threatening if not diagnosed and treated promptly. During pregnancy, the disease can progress silently but with severe consequences.
Approximately 80% of Budd-Chiari syndrome cases are linked to blood clotting disorders such as myeloproliferative neoplasms, cancers (liver, kidney, adrenal gland, right atrium), benign liver tumors, abdominal aortic aneurysms, and notably, pregnancy or the use of birth control pills, accounting for up to 20% of diagnosed cases. Additional causes can include congenital structural abnormalities in the inferior vena cava or other congenital abnormalities of the hepatic veins.
"During pregnancy, a woman's body tends to increase blood clotting in preparation for childbirth. If a pregnant woman has a pre-existing blood clotting disorder that goes undetected, the risk of thromboembolism, especially in large blood vessels like the hepatic veins, is entirely possible," Dr. Huyen explained.
Doctors recommend that pregnant women with a history of recurrent miscarriages, stillbirths of unknown cause, early preeclampsia, or family history of thromboembolism undergo screening for blood clotting disorders before and during pregnancy. Women experiencing symptoms such as rapid abdominal swelling, liver pain, jaundice, leg swelling, or persistent fatigue should seek immediate medical attention.
Thuy Quynh
