Liver hydatid diseases of the pregnancy: Management approaches and outcomes

Background: Although hepatic hydatid disease is infrequent during pregnancy, it could be hazardous for both the mother and the fetus. Most cases of hydatid cysts during pregnancy are asymptomatic and discovered accidentally during prenatal care. The diagnosis of hepatic hydatid disease is easy and straightforward but the management is difficult and problematic. Objective& method: We present 12 pregnant patients of various gestational age discovered to have hepatic hydatid disease during antenatal period or for investigation for non-specific symptoms. Their representations, diagnosis and treatments options and outcomes were studied and assessed. Results: A retrospective cohort study in which 12 consecutive pregnant patients of different gestational ages diagnosed incidentally or due to non-specific symptoms to have hydatid liver diseases. The age ranges from 18 to 42 year (mean 31.5 years). The size of the cysts measured by ultrasound ranges between 3 cm and 8.5 cm (average 4.8 cm). Four asymptomatic patients were managed by expectant observation and close follow-up, tow patients were managed by anthelminthic drug (Albendazole), four symptomatic large (>5 cm) and palpable cysts underwent PAIR procedure and the last two patients were submitted to surgery in form of pericystectomy due to their acute symptomatic presentation. No mortality occurred and all neonates were healthy with no congenital anomalies. Conclusions: Up to now there is no consensus of the management of hydatid disease during pregnancy and each case should be individualized. Observations with close follow up, medical treatment using anthelminthic drugs such as albendazole, percutaneous aspiration and surgery are treatment options. Highlights