Peer-reviewed article
Abdominopelvic hydatid disease during pregnancy: a systematic review of the literature.
Chinis E, Tzanakis K, Lockett G, Ellis LB, Bobotis S et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a systematic review of medical literature on a parasitic infection (cystic echinococcosis) affecting pregnant women. It reports on clinical presentation, diagnosis, and treatment outcomes from 79 cases. While it involves pregnancy and some adverse outcomes, it is a clinical medical review rather than research on child well-being or outcomes for children.
Key points
- 79 cases of abdominopelvic hydatid disease during pregnancy were identified across 51 studies
- Liver involvement was most common (69.4%), presenting with abdominal pain in 83.6% of symptomatic cases
- Preterm birth occurred in 36.1% of pregnancies with reported gestational age at delivery
- Management was heterogeneous: surgery in 38.5%, conservative management in 30.8%, cyst aspiration in 14.1%
- Adverse outcomes included miscarriage (4.5%), termination (3.0%), one maternal death and one neonatal death
Limitations
This review focuses on maternal outcomes and pregnancy management rather than child well-being or child development outcomes. The evidence base is limited to case reports and small case series with substantial heterogeneity, and there is no assessment of long-term effects on children born to affected mothers.
Abstract
Objective To review the available literature on abdominopelvic cystic echinococcosis (CE) during pregnancy, focusing on clinical presentation, diagnostic approaches, management strategies, and maternal and foetal outcomes. Methods A systematic review was conducted in accordance with PRISMA guidelines. Studies reporting abdominopelvic hydatid disease in pregnant women were included without restrictions on study design or geography. Results Fifty-one studies (45 case reports and 6 case series) including 79 patients were analysed. The mean maternal age was 28 years (range 15-42). Most patients with reported clinical-presentation data were symptomatic (56/67, 83.6%), commonly presenting with right upper quadrant or nonspecific abdominal pain. Ultrasound was the primary diagnostic modality (50/52, 96.1%), while MRI was used in selected cases. The liver was the most frequently involved site (50/72, 69.4%), followed by pelvic and adnexal locations. Surgical intervention was performed in 38.5% of cases, conservative management in 30.8%, and cyst aspiration in 14.1%. Surgery was often timed during caesarean section or the second trimester. Benzimidazole therapy was administered to 31 patients, most commonly during pregnancy. Caesarean delivery occurred in 43.3% and vaginal delivery in 34.3% of cases. Adverse pregnancy outcomes included miscarriage (4.5%), termination of pregnancy (3.0%), one maternal death (1.5%), and one neonatal death (1.5%). Among the 36 pregnancies with reported gestational age at delivery, 13 (36.1%) resulted in preterm birth. Conclusion Abdominopelvic CE during pregnancy is rare and clinically challenging, with substantial heterogeneity in presentation and management across the published literature. Given the limited available evidence, management should be individualised within a multidisciplinary team, while prospective international registries are needed to strengthen the evidence base.