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Medical News: Pregnancy in the Liver

Discussion in 'Gynaecology and Obstetrics' started by Hadeel Abdelkariem, Feb 24, 2019.

  1. Hadeel Abdelkariem

    Hadeel Abdelkariem Golden Member

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    Few days ago a colleague of mine showed the video of a real time pregnancy in the liver, I couldn't believe my eyes. I did some research and I forwarded the video to sonographers group on Facebook, that caused a stir of international interest. 99.9% of experienced sonographers have never seen it before, 90% had never heard about it. Now I can imagine how ignorant the general public is about this.

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    This case was reported in Namibia on the 13th December, 2018. Below is a documented case in the literature to enlighten the reader.

    The video below is a recent finding in Namibia



    Reported case

    As reported by journal of emergency, trauma and shock

    Primary hepatic pregnancy

    Reena Yadav, Chitra Raghunandan, [...], and Sarita Chowdhary

    Abdominal pregnancy is a rare type of ectopic pregnancy with an estimated incidence being 1 in 8,000 births and 1.4 % of all ectopic pregnancies. Most commonly, the site of implantation in an abdominal pregnancy is pelvic, but very rarely it may implant in the upper abdomen. The authors report such a case of primary hepatic pregnancy on account of its rarity and the therapeutic dilemmas.

    Case report

    A 25-year-old G2P1L1 woman with 18-week pregnancy presented with right hypochondriac pain and vomiting for the past 1 week. She had borderline vitals and a diffusely tender abdomen. Ultrasound revealed a live 18-week fetus attached to the undersurface of the liver with moderate ascites. Laparotomy was carried out which revealed 500 cc of hemoperitoneum with a primary hepatic pregnancy of the right lobe of liver and bleeding from the placental site. After extracting the fetus, the placenta was left inn situ and the abdomen was packed to control the bleeding as other hemostatic measures failed. Hepatic artery embolization was done after surgery followed by relaparotomy but the abdomen had to be repacked again as the patient was unstable with uncontrollable bleeding. The patient succumbed to DIC despite adequate replacement. In retrospect, the authors conclude that embolization could have been done before surgery and partial hepatic resection attempted in the first instance.

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    Intrahepatic cyesis as seen in Namibia

    Article information
    J Emerg Trauma Shock. 2012 Oct-Dec; 5(4): 367–369.
    doi: 10.4103/0974-2700.102417
    PMCID: PMC3519057
    PMID: 23248513
    Reena Yadav, Chitra Raghunandan, Swati Agarwal, Shilpa Dhingra, and Sarita Chowdhary
    Department of Obstetrics and Gynaecology, Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital, New Delhi, India
    Address for correspondence: Dr. Swati Agarwal, E-mail: moc.liamg@liamitawsrd

    Source
     

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    Last edited by a moderator: Mar 2, 2019

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