RESUMEN
To evaluate the hepatic and obstetric complications in pregnant women with cirrhosis. We report the cases of four pregnant women with cirrhosis treated in the gastroenterology and obstetrics-gynecology departments of the Lome Campus University Teaching Hospital between 2013 and 2015. The women's mean age was 32 years. Three were in the first trimester of pregnancy. Almost all had signs of advanced cirrhosis, including ascites (50%), lower-limb edema (75%), and jaundice (25%). All (100%) had liver failure and anemia. Cirrhosis was due to hepatitis virus B infection for 3 women. All had singleton pregnancies. Two mothers died; fetal outcome included one fetal loss and one stillbirth. This study shows the high risk associated with the combination of pregnancy and cirrhosis. Prognosis is poor for both mother and fetus.
Asunto(s)
Cirrosis Hepática , Complicaciones del Embarazo , Adulto , Femenino , Hospitales Universitarios , Humanos , Cirrosis Hepática/diagnóstico , Embarazo , Complicaciones del Embarazo/diagnóstico , Togo , UniversidadesRESUMEN
OBJECTIVE: To report a series of cases of anencephaly in twin pregnancies and assess the prognosis of the normal twin. PATIENTS AND METHODS: Retrospective study covering 4 years, at the CHU Campus in Lomé, assessing the sonographic aspects and management of cases of anencephaly in twin pregnancies. RESULTS: Anencephaly was found in 6 twin pregnancies. The mothers' mean age was 31 years and all had a very low socioeconomic status. All had drunk a plant infusion of an unknown chemical composition in early pregnancy. Mean gestational age at diagnosis was 25 weeks. Ultrasound performed in all cases showed that 5 cases involved monochorionic diamniotic placentas, and 1 case a dichorionic placenta. Both fetuses were alive at diagnosis in all cases: one had anencephaly and the other twin was normal. The average estimated weight of the anencephalic twin at diagnosis was 659 grams, and of the normal twin, 749 grams; growth was thus discordant. Hydramnios was noted in all cases. Expectant monitoring was instituted; both twins died before 30 weeks in 4 cases. CONCLUSION: Anencephaly in twin pregnancy is a rare occurrence. Ultrasound can be involved in the diagnosis and management.