A rare case of Weil’s disease in pregnancy - a case report
Leptospirosis is a rare zoonotic disease caused by spirochaete of the genus Leptospira. About 5-10% of patients manifest as severe disease known as Weil’s disease associated with high fatality. Infection in pregnancy is uncommon and moreover it may mimic viral hepatitis, acute fatty liver in pregn...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Barpeta Obstetrics and Gynaecological Society
2024-05-01
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| Series: | New Indian Journal of OBGYN |
| Subjects: | |
| Online Access: | https://journal.barpetaogs.co.in/pdf/10446.pdf |
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| Summary: | Leptospirosis is a rare zoonotic disease caused by spirochaete of the genus Leptospira. About 5-10% of patients
manifest as severe disease known as Weil’s disease associated with high fatality. Infection in pregnancy is uncommon
and moreover it may mimic viral hepatitis, acute fatty liver in pregnancy (AFLP), pregnancy induced hypertension
(PIH) and HELLP (hemolysis, elevated liver enzymes, low platelet) syndrome. A 23 year old, primigravida (34 weeks
gestation) who is Rh negative and not in labour was referred to our hospital in view of persistent hypotension and
bradycardia. Prior to this, patient had complaints of swelling of lower limbs since 15 days and cough with
expectoration, sore throat and dysphagia, fever 1 week ago followed by jaundice, epistaxis and hematochezia. Patient
had blood pressure recording of 80/40 mm Hg, pulse -40bpm on admission. On further evaluation she was negative
for dengue, malaria but leptospira positive. She was severely anemic with deranged hepatic and renal functions and
diagnosed to be disseminated intravascular coagulation (DIC) with decompensatory shock. Preterm lower segment
caesarean section (PTLSCS) was done in view of failed induction and a fresh still born baby of weight 2.2 kg was
extracted. Patient had severe postpartum hemorrhage (PPH) and due to failed medical management, stepwise
devascularisation was performed followed by peripartum hysterectomy and was shifted to ventilator due to persistent
hypotension. On the postoperative day 2, patient blood pressure did not pick up and patient died of DIC
complications. In pregnant women, early identification of the disease is required to avoid complications as well as
fetal and maternal mortality. |
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| ISSN: | 2454-2334 2454-2342 |