Hepatic hydatid disease requiring urgent treatment during pregnancy

Background: Pregnant women may experience acute presentation of hepatic hydatid disease. The available literature is limited to case reports.
Methods: The charts of 7 patients who underwent urgent treatment for hepatic hydatid disease during pregnancy between 1992 and 2010 were reviewed.
Results: Median (range) patient age was 27 (23-39) years and median (range) gestational age 18 (13-24) weeks. The symptoms were severe abdominal pain (4), vomiting (2), jaundice (2), pruritus (2) and severe dyspepsia (1); in the asymptomatic patient, a closed intraperitoneal rupture had been detected during gynecologic ultrasonography. Surgical drainage of the cysts was performed in all cases. The two patients with frank biliary rupture underwent choledochoduodenostomy or Roux-Y hepaticojejunostomy. Four patients required postoperative tocolysis. Albendazole was not used. All mothers gave birth to healthy babies at term. The patients could be followed for median (range) 9(4-19) years. Two patients developed recurrences at 2 and 7 years; these were treated with surgical drainage and albendazole.
Conclusions: This entity entails the responsibility of two human beings. Although it imposes limitations on the routine diagnostic and therapeutic options due to risk of premature labor or teratogenicity, acceptable results can be obtained in collaboration with the department of obstetrics and gynecology.