Pregnancy and Large Liver Hydatid Cyst

Complicated liver hydatid cysts are rare in pregnant women. Its management may have many particularities. The aim of our study was to describe clinical, morphological features, and therapeutic modalities of complicated hydatid cysts in pregnant women. We conducted a case series analysis and a monocentric study, including patients who presented a complicated hydatid cyst during pregnancy, admitted in our surgical department, over a period of 11 years. A total of 8 patients were included. Mean age was 26.1 SD 4 years. Mean term was 16.7 SD 5 weeks. All patients had abdominal pain; one patient had fever; and no patient was icteric. Hyperleukocytosis was present in 2 patients; C-reactive protein was elevated in 2 patients; and liver function tests were disturbed in 3 patients. In abdominal ultrasound, hydatid cyst was located in the right liver in 5 cases and in the left liver in 3 cases. Average size of cysts was 7.6 SD 2.1 cm. All the patients underwent surgery. The approach was a right subcostal incision in 6 cases and a midline incision in 2 cases. “Lagrot” procedure was performed in 7 cases and bipolar drainage in one case. Postoperative course was simple in 6 cases. One patient presented a miscarriage at 10 weeks. Another patient presented an abdominal wall abscess. Complicated hydatid cysts in pregnant women have a noiseless clinical presentation. Abdominal ultrasound is the morphological examination of choice. Conservative treatment is preferred. Fetal prognosis is better if operation is performed during the second trimester.