The discovery seems not very believable. In India, a rare medical case recently moved the medical community. A 30 -year -old woman was diagnosed with 12 weeks pregnant, but the fetus did not develop in her uterus … He had established himself in her liver. An amazing phenomenon, with less than 30 known cases in the world.
An unexpected discovery
The patient, originally from Bulandshahr, in the state of Uttar Pradesh, did not know herself. She had suffered from abdominal pain and persistent vomiting for several weeks, without finding the cause. Over the consultations a certainty is done, it must pass an MRI. It was then that Dr. Kk Gupta, radiologist, identified a fetus living in the right lobe of his liver. A fetus of several weeks with cardiac activity.
“It was a confirmed pregnancy of 12 weeks, located in the liver rather than in the uterus”, confirmed the doctor. According to him, there are only 18 cases identified in the world, and none in India so far. The patient was immediately transferred to the All India Institute of Medical Sciences (AIMS) in Delhi for specialized care. Surgery, to release the mother from this non -viable pregnancy, which could have been fatal to her.
How can an embryo lodge in the liver?
The necessary question is simple “How can an embryo, then a fetus, be in the liver? ” The answer can amaze. The pregnancy observed belongs to the family of extra-uterine pregnancies, also called ectopic pregnancies, which occur when the embryo does not set up in the uterus. In most cases (97%), it remains blocked in a fallopian tube. But, exceptionally, the egg can be found in the abdominal cavity.
As surprising as it may seem, Dr. Jonas Benguigui, gynecologist-obstetrician, explains: “Instead of following the normal path to the uterus, the embryo can be drawn into the brewing of peritoneal fluid and find itself in the belly. The liver, very vascularized, then becomes a site conducive to implantation.” In other words, the fetus can take advantage of the rich blood vessels of this organ to continue its growth.
A phenomenon that an article in the world already explained in 2017. “This implantation site is very favorable for the development of the egg insofar as the liver is a very richly vascularized organ. The trophoblast (external cell layer of the egg and future draft of the placenta) can then use the vessels present on the underside of the liver and continue its growth. It emits extensions (trophoblastic villi) which are gradually fitting into the liver. ”
A difference in diagnosis between countries
For Dr. Benguigui, it is however the difference in care according to the country which made it possible to see this rarity. “”In France, we generally detect extrautterin pregnancies very early on, thanks to beta-HCG dosages and early ultrasounds. The treatment can then be medical, with an injection of methotrexate. But in India, where follow -up is not as homogeneous, some atypical pregnancies can evolve longer, until it becomes symptomatic. “
This is precisely what happened to this patient, which was only diagnosed once the abdominal pain that has become unbearable.
A non -viable pregnancy. A vital danger for the mother
This type of pregnancy cannot be completed. Beyond 14 weeks, the risks become major: internal hemorrhages, rupture of the organ, and even maternal death. “”It is extremely dangerous, because the liver is a very vascularized organ. In the event of a break, the patient can empty her blood in a few minutes “alerts Dr. Benguigui.
The only possible treatment, once the fetus is implanted in the liver, therefore remains surgical. It is often a partial ablation of the liver including the area where the embryo has nestled. A heavy operation, which must be carried out in a specialized center.
He was several livers
It was not the first time that an intrahepatic pregnancy has been talked about. Isolated cases have been reported worldwide: in China in 2017, and even in France in 1999, and barely twenty others for fifty years. Most do not exceed the first quarter. Bulandshahr’s pregnancy therefore joins the list of the most impressive medical anomalies ever described.