Challenges in the management of vascular liver disorders in women in the reproductive period.

Vascular liver diseases (VLD) are a heterogeneous cohort of uncommon hepatic diseases which affect individuals particularly in the reproductive age group. They are typically associated with inherited or acquired thrombophilia. These diseases may influence reproductive health in women through alteration of the menstrual cycle and impact fertility. Pregnancy in this patient group may be complicated by exacerbation of portal hypertension, maternal and fetal complications due to underlying liver disease or drugs used for its management. This review focuses on the known risk factors of VLD in women, along with their prevalence and management. Special situations such as impact and use of anti-coagulants in pregnancy, management of portal hypertension and variceal bleeding, safe contraceptive use in this patient group and safety and risk of in-vitro fertilization are also discussed.