Pregnancy in a patient with acute porphyria

ABSTRACT

A 27 years old female was diagnosed to have acute intermittent porphyria in 1997. In 2002 she became pregnant. The first trimester was uneventful obstetrically but the duration, frequency and severity of porphyria attacks increased. As the pregnancy advanced to second trimester the condition of patient deteriorated. The symptoms were continuous with no period of relief. In the third trimester she became increasingly irritable and dyspnoeic, and developed facial edema, muscle weakness, and fecal and urinary incontinence. At 33 weeks of gestation USG showed absent liquor and decreased fetal movements; S/D [systolic diastolic ratio] was increased [>4.3]. Elective Cesarean-section was performed at 33 weeks. Her condition settled in one week. Porphyria is an uncommon disorder. It affects women more frequently than men. Not only it has adverse effects on pregnancy but the frequency of porphyria attacks also increases during pregnancy. We herewith present a case report of a female with acute intermittent porphyria who conceived