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应对复杂性:一例罕见的妊娠肝内胆汁淤积症合并前置胎盘并伴有癫痫发作的病例

Navigating the Complexities: A Rare Case of Intrahepatic Cholestasis of Pregnancy With Placenta Previa Manifesting With Seizures.

作者信息

Salvi Pankaj, Bhadoriya Ayushi, Gaikwad Vidya, Hatwar Himali, Aramandla Sneha, Dsouza Ashton

机构信息

Obstetrics and Gynaecology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.

出版信息

Cureus. 2024 Aug 21;16(8):e67385. doi: 10.7759/cureus.67385. eCollection 2024 Aug.

Abstract

Intrahepatic cholestasis of pregnancy (ICP) is a prevalent and reversible liver disorder that occurs during pregnancy. It is primarily characterized by itching, especially on the palms and soles, and elevated levels of transaminases and bile acids. Some patients may also exhibit hyperbilirubinemia. This condition generally has a good maternal prognosis. The patient, in this case, presented with severe itching, elevated liver enzymes and bile acids, and an ultrasound indicated placenta previa. Uniquely, she experienced an episode of seizure and high blood pressure following surgery. This case report underscores the need for vigilant monitoring of patients with ICP, not only during pregnancy due to the risk of adverse perinatal outcomes but also for antenatal and postpartum complications.

摘要

妊娠期肝内胆汁淤积症(ICP)是一种在妊娠期间发生的常见且可逆的肝脏疾病。其主要特征为瘙痒,尤其是手掌和脚底,以及转氨酶和胆汁酸水平升高。部分患者可能还会出现高胆红素血症。这种情况总体上对母亲的预后良好。在此病例中,患者表现为严重瘙痒、肝酶和胆汁酸升高,超声检查显示前置胎盘。独特的是,她在手术后出现了一次癫痫发作和高血压。本病例报告强调了对ICP患者进行密切监测的必要性,不仅因为妊娠期间存在不良围产期结局的风险,还因为产前和产后并发症。

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