BUDD-CHIARI SYNDROME COMPLICATING SEVERE PREECLAMPSIA IN A PARTURIENTWITH PRIMARY ANTIPHOSPHOLIPID SYNDROME

A 27-year-old primipara with severe preeclampsia and primary antiphosp holipid syndrome developed right upper quadrant pain, massive ascites, HELLP syndrome, and disseminated intravascular coagulation shortly fo llowing vaginal delivery. Computed tomography and color Doppler studie s were compatible with complete thrombosis of the right hepatic veins, the Budd-Chiari syndrome. Anticoagulation was initiated, along with s upportive measures, and the patient recovered completely. Imaging stud ies 6 months later were normal. This case demonstrates that nearly fat al-forms of venous thrombosis may complicate preeclampsia in women wit h antiphospholipid syndrome; Doppler studies of the hepatic vein are o f value in establishing the diagnosis.