Echinococcosis: An Obstetric and Gynecologic View

Abstract

Four patients had echinococcosis that required obstetric and gynecologic management. Patients under treatment for echinococcosis require timely contraceptive or prepregnancy advice, although reproductive function is rarely affected by the hydatid.EA Kidess, AS Akiel, HS Ba'aqeel, SS Malaika, Echinococcosis: An Obstetric and Gynecologic View. 1988; 8(3): 202-205 MeSH KEYWORDS: Echinococcosis; Pregnancy complications Human echinococcosis is relatively common in Saudi Arabia, and the sex incidence of patients with echinococcosis is 62.8% and 37.2% for females and males, respectively, with maximal incidence between the ages of 25 and 40 years, 1 the fertile age of females. Although mortality is low, complications may occur to make its morbidity of great interest in obstetrics and gynecology, especially in a country where pregnancy and motherhood are high priority. Here we describe four cases that stimulated us to evaluate and review the management of echinococcosis from obstetric and gynecologic viewpoints. Case Reports Case 1A 39-year-old woman, gravida 5, para 3 + 1, was referred with secondary amenorrhea of six weeks' duration and a positive pregnancy test. She had a four-year history of pain in the upper right quadrant of the abdomen. Four months prior to consultation, she underwent surgery for removal of a 5.7 × 5.2 cm hydatid cyst containing multiple daughter cysts from the right and left lobes of the liver with involvement of the diaphragm. Post-operatively a sixmonth course of mebendazole was prescribed. Four weeks prior to consultation, she was admitted with upper right quadrant pain, and fluid was aspirated from the right subdiaphragmatic area. For maternal medical indications, termination of pregnancy was approved. The patient underwent suction curettage, and an intrauterine contraceptive device was inserted. Both husband and wife refused tubal ligation. The histopathology report confirmed the presence of products of conception. This patient continued to receive mebendazole therapy. Case 2A 30-year-old woman, para 6 + 1, with regular menstrual cycles and no gynecological complaints gave a fouryear history of heaviness in the right hypochondrium. This became a colicky pain of a few weeks' duration and prompted her admission to the surgical service. Clinical, sonographic, and radiologic investigations suggested a hydatid cyst, and hydatid serology was positive. Liver function tests were normal. She underwent surgery, and a hydatid cyst measuring 12 × 15 cm and smaller multiple cysts were removed from the right lobe of the liver. Echinococcosis: An Obstetric and Gynecologic ViewAnnals of Saudi Medicine, Vol 8 No. 3; 1988 Postoperatively she received a six-month course of mebendazole. At postoperative consultation, contraception was advised, and an intrauterine contraceptive device was inserted. Case 3A 36-year-old woman, gravida 3, para 2 + 0, had regular menstrual cycles and an unremarkable gynecologic history. She presented for antenatal care at nine weeks' gestation. Her first pregnancy fiv...

Ultrasound Wall-Sign in Pulmonary Echinococcosis (New Application)

“…the lung is the second most common site (18 -35 %) [5,6]. The incidence of concomitant liver and lung hydatidosis varies from 5.8 -13.3 % [2,3]. Most CE cases are diagnosed by a combination of clinical findings, medical imaging and serological tests.…”

“…Hippocrates described the human echinococcal disease more than two thousand years ago with the term "hydatid" or "liver filled with water" [1]. The exact life cycle of the parasite, however, was recognised by Dew et al only in 1928 [2,3]. Cystic echinococcosis (CE) has a wide and cosmopolitan geographical distribution.…”

Bilateral ruptured pulmonary hydatid cysts

“…[3] Surgical treatment constitutes 0.3% of the operative general surgical load and 5% of all major surgical procedure. [2,4] …”

An Imported Case of Echinococcosis in a Pregnant Lady with Unusual Presentation

“…Al-Rahzes, the famous physician, subsequently wrote on hydatid cyst of the liver about thousand years ago [3]. Currently, hydatid disease is classified among the most neglected parasitic diseases [4, 5].…”