Extra hepatic portal vein obstruction and pregnancy outcome: largest reported experience

J Obstet Gynaecol Res. 2011 Jun;37(6):575-80. doi: 10.1111/j.1447-0756.2010.01407.x. Epub 2011 Mar 6.

Abstract

Aim: Evaluate pregnancy outcome in women with extra hepatic portal vein obstruction (EHPVO).

Material & methods: A total of 26 pregnancies in 14 women with EHPVO were evaluated for maternal and perinatal outcomes in a tertiary centre of Northern India. Fourteen pregnancies were evaluated prospectively while the details of 12 previous pregnancies in the same women were studied retrospectively.

Results: Mean age of pregnant women with EHPVO was 24.5 years and approximately one-third were primigravidae. Only one patient was diagnosed as EHPVO in the index pregnancy. The presenting event was hematemesis in 71% of the patients; others presented with thrombosis, pain abdomen and jaundice or incidental splenomegaly. The incidence of abortion, preterm deliveries and still births was 20%, 15.4% and 7.7%, respectively. Underlying hypercoagulable and prothrombotic state was diagnosed in around one-fifth of the patients. Half of these women required platelet transfusion in the intrapartum period due to hypersplenism resulting in thrombocytopenia. Anemia was seen in 40% of the patients; however, no other major complications were seen as a result of EHPVO. The vaginal delivery rate and obstetrical outcome were similar as in general population.

Conclusion: Pregnancy outcome is expected to be successful in women with EHPVO if disease is adequately controlled prior to pregnancy.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • India
  • Portal Vein / diagnostic imaging
  • Portal Vein / pathology*
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / diagnostic imaging
  • Pregnancy Complications, Cardiovascular / pathology*
  • Pregnancy Complications, Cardiovascular / physiopathology*
  • Pregnancy Complications, Cardiovascular / therapy
  • Pregnancy Outcome*
  • Prospective Studies
  • Ultrasonography
  • Vascular Diseases / diagnostic imaging
  • Vascular Diseases / pathology*
  • Vascular Diseases / physiopathology*
  • Vascular Diseases / therapy
  • Young Adult