Murali Subbaiah1, Sunesh Kumar2, Kallol Kumar Roy2, Jai Bhagwan Sharma2, Neeta Singh2. 1. Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India. Electronic address: muralidraiims@gmail.com. 2. Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.
Abstract
BACKGROUND: Extrahepatic portal-vein obstruction (EHPVO) is a common cause of portal hypertension in developing countries. The main risk in pregnant women with this condition is variceal bleeding, which may be life-threatening. The objective of our study was to assess the outcome of pregnancy in women with EHPVO. MATERIALS AND METHODS: A retrospective analysis of 21 pregnancies in 12 women with EHPVO was carried out at a tertiary hospital in India. RESULTS: The mean age of pregnant women with EHPVO was 25.3 years, and the mean duration of disease since diagnosis was 6.1 ± 1.2 years. All the patients had chronic EHPVO, and two patients were diagnosed in the index pregnancy. The incidence of abortion, preterm deliveries, and small for gestational age fetus was 23.8%, 18.7%, and 12.5%, respectively. Thrombocytopenia was found to complicate 61.9% of the pregnancies, while anemia was detected in 40% of the pregnancies. Variceal bleeding occurred in one woman, who was diagnosed during pregnancy and was managed successfully with endoscopic sclerotherapy. None of the patients who were diagnosed prenatally had variceal bleeding during pregnancy. The outcome in nine pregnancies, in which prenatal endoscopic variceal ligation was done, was compared with eight pregnancies, in which endoscopic sclerotherapy was done. No significant difference between the two groups in terms of pregnancy outcome and complications was found. There were no stillbirths or maternal mortality. CONCLUSION: Women with EHPVO who have been diagnosed and treated prenatally have a good pregnancy outcome. They should be managed in a tertiary care center with a multidisciplinary approach.
BACKGROUND: Extrahepatic portal-vein obstruction (EHPVO) is a common cause of portal hypertension in developing countries. The main risk in pregnant women with this condition is variceal bleeding, which may be life-threatening. The objective of our study was to assess the outcome of pregnancy in women with EHPVO. MATERIALS AND METHODS: A retrospective analysis of 21 pregnancies in 12 women with EHPVO was carried out at a tertiary hospital in India. RESULTS: The mean age of pregnant women with EHPVO was 25.3 years, and the mean duration of disease since diagnosis was 6.1 ± 1.2 years. All the patients had chronic EHPVO, and two patients were diagnosed in the index pregnancy. The incidence of abortion, preterm deliveries, and small for gestational age fetus was 23.8%, 18.7%, and 12.5%, respectively. Thrombocytopenia was found to complicate 61.9% of the pregnancies, while anemia was detected in 40% of the pregnancies. Variceal bleeding occurred in one woman, who was diagnosed during pregnancy and was managed successfully with endoscopic sclerotherapy. None of the patients who were diagnosed prenatally had variceal bleeding during pregnancy. The outcome in nine pregnancies, in which prenatal endoscopic variceal ligation was done, was compared with eight pregnancies, in which endoscopic sclerotherapy was done. No significant difference between the two groups in terms of pregnancy outcome and complications was found. There were no stillbirths or maternal mortality. CONCLUSION:Women with EHPVO who have been diagnosed and treated prenatally have a good pregnancy outcome. They should be managed in a tertiary care center with a multidisciplinary approach.
Authors: Cuoghi Edens; Bruna Costa Rodrigues; Marcela Ignacchiti Lacerda; Flavia Cunha Dos Santos; Guilherme R De Jesús; Nilson Ramires De Jesús; Roger A Levy; Cianna Leatherwood; Jess Mandel; Bonnie Bermas Journal: Rheumatology (Oxford) Date: 2018-07-01 Impact factor: 7.580
Authors: Hmg Wiegers; E N Hamulyák; S E Damhuis; J R van Duuren; S Darwish Murad; Ljj Scheres; S J Gordijn; J Leentjens; J J Duvekot; M N Lauw; B A Hutten; S Middeldorp; W Ganzevoort Journal: BJOG Date: 2021-10-04 Impact factor: 7.331