Acute exacerbation of hepatitis B with hepatic failure during the first trimester of pregnancy: Delivery of a healthy term baby after liver transplantation.
Jin-Chiao LeePei-Hua LiTze-Yee MokShu-Han YouHao-Chien HungChen-Fang LeeHong-Shiue ChouWei-Chen LeePublished in: Hepatology research : the official journal of the Japan Society of Hepatology (2020)
The severe form of acute exacerbation of hepatitis B during pregnancy is a rare but life-threatening condition for both the mother and the fetus. A 32-year-old pregnant woman at 10 weeks of gestation was diagnosed with acute decompensated liver failure due to acute exacerbation of hepatitis B. The Model for End-stage Liver Disease score was up to 37. The patient was managed carefully with antiviral treatment, fluid resuscitation, correction of coagulopathy, close monitoring of hepatic function, and regular assessment of the fetus. She was transplanted with a deceased liver at 14 weeks and 1 day of gestation. With careful post-transplant care and avoidance of medication with risk of miscarriage and teratogenicity, a healthy baby was delivered at 39 weeks and 1 day of gestation. Herein, we report this critical condition of pregnancy that was complicated with liver failure due to acute exacerbation of hepatitis B, but had favorable outcomes for both the mother and the baby after liver transplantation.
Keyphrases
- liver failure
- hepatitis b virus
- chronic obstructive pulmonary disease
- gestational age
- preterm infants
- respiratory failure
- preterm birth
- pregnant women
- type diabetes
- case report
- emergency department
- cardiac arrest
- drug induced
- metabolic syndrome
- early onset
- insulin resistance
- skeletal muscle
- intensive care unit
- weight loss
- adverse drug
- affordable care act
- electronic health record
- mechanical ventilation
- clinical evaluation