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Pregnancy and liver transplantation
E R Newton1, N Turksoy, M Kaplan
1Department of Obstetrics and Gynecology, Tufts University School of Medicine, Tufts Affiliated Hospitals, Boston, Massachusetts.
Obstetrics and Gynecology
|March 1, 1988
Summary
Pregnancy after liver transplant led to placental abruption and preterm birth. The mother experienced a postpartum midgut volvulus, but both survived after extended hospital care.
Area of Science:
- Reproductive medicine
- Transplant surgery
- Gastrointestinal surgery
Background:
- Orthotopic liver transplantation (OLT) is a life-saving procedure.
- Pregnancy following OLT presents unique maternal and fetal risks.
- Roux-en-Y gastrojejunostomy is a common surgical reconstruction technique.
Observation:
- A pregnant patient with a history of OLT developed abruptio placentae and preterm delivery at 27.5 weeks.
- The postpartum period was complicated by a midgut volvulus.
- The volvulus occurred through a mesenteric defect within the Roux-en-Y loop reconstruction.
Findings:
- The case highlights the potential for severe obstetric complications after OLT.
- Midgut volvulus is a rare but serious postpartum complication in OLT recipients with Roux-en-Y reconstruction.
- Successful management of both mother and infant was achieved.
Implications:
- Close multidisciplinary monitoring is crucial for pregnant OLT recipients.
- Awareness of potential gastrointestinal complications in OLT patients with Roux-en-Y loops is essential.
- This case underscores the importance of prompt surgical intervention for postpartum midgut volvulus.