Recurrent preeclampsia in a pregnant woman with Klippel-Trenaunay syndrome: two cesarean deliveries and multiple extremity involvement - a case report and literature review.

Abstract

Background: In this study, a total of 17 patients with Klippel-Trenaunay Syndrome (KTS) and pregnancy were evaluated. The patients were divided into two groups: those with organ involvement (10 patients) and those without organ involvement (7 patients). The clinical findings, complications, and treatment approaches between the two groups were compared, and the effects of KTS on the pregnancy process and potential risks were examined in detail. Significant clinical differences were observed between pregnant women with involvement of abdominal organs such as the liver, spleen, rectum, sigmoid, kidney, bladder, and uterus, as well as central organs like the brain, and those without such involvement. Organ involvement was defined as organ enlargement or venous anomalies detected by techniques such as ultrasound, magnetic resonance imaging (MRI), or computed tomography. Our literature review found that the risk of postpartum hemorrhage (PPH) was significantly higher in the group with organ involvement (p < 0.05). The presence of varicose malformations in organs such as the spleen, liver, and uterus was identified as an important factor increasing the risk of PPH. Therefore, close monitoring of coagulopathic disorders and taking precautions against thromboembolism in pregnant women with KTS is crucial. The case report discusses the complications and treatment processes experienced by a 26-year-old woman diagnosed with KTS and who developed preeclampsia during her two pregnancies. Complications such as preeclampsia and varices were observed in the first pregnancy, and intrauterine growth restriction (IUGR) and preeclampsia in the second pregnancy. Successful outcomes were achieved in both cases with a multidisciplinary approach and appropriate treatment methods. This study provides important information to understand the effects of KTS on pregnancy and the potential complications associated with this rare condition. Future studies will provide more information on the management of preeclampsia and other complications in pregnant women with KTS.