European journal of obstetrics, gynecology, and reproductive biology · 2025
Clinical profile and perinatal outcomes in pregnant women with extrahepatic portal venous obstruction: A case series from eastern India.
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Sontakke Neelu Rajkumar, Begum Jasmina, Mitra Subarna, Singh Sweta
Аннотация
OBJECTIVE: To study the clinical profile and perinatal outcomes in pregnant women with extrahepatic portal venous obstruction (EHPVO).
METHOD: Data of pregnant women with EHPVO that were managed in the department of obstetrics and gynaecology at a tertiary care institute in eastern India over the last 3 years was collected and analyzed. Antenatal care, transfusion requirement, frequency of upper gastrointestinal endoscopy and endoscopic variceal ligation (EVL) and maternal and neonatal outcomes were studied.
RESULT: A total of 6 pregnant women with EHPVO were managed. Three were diagnosed before pregnancy and had history of EVL while the other three were diagnosed during index pregnancy. Four out of 6 women required blood transfusion. Anaemia, thrombocytopenia and fetal growth restriction were seen in four cases, along with splenomegaly and portal hypertension. Two women with EHPVO who had splenectomy prior to pregnancy had uneventful antenatal and postnatal period.
CONCLUSION: A multidisciplinary approach should be followed in pregnant women with EHPVO. We should be vigilant about risk of variceal bleeding which is a life-threatening complication of EHPVO. Splenectomy prior to pregnancy might lower the risk of maternal and fetal morbidity and help to achieve favourable outcomes.
METHOD: Data of pregnant women with EHPVO that were managed in the department of obstetrics and gynaecology at a tertiary care institute in eastern India over the last 3 years was collected and analyzed. Antenatal care, transfusion requirement, frequency of upper gastrointestinal endoscopy and endoscopic variceal ligation (EVL) and maternal and neonatal outcomes were studied.
RESULT: A total of 6 pregnant women with EHPVO were managed. Three were diagnosed before pregnancy and had history of EVL while the other three were diagnosed during index pregnancy. Four out of 6 women required blood transfusion. Anaemia, thrombocytopenia and fetal growth restriction were seen in four cases, along with splenomegaly and portal hypertension. Two women with EHPVO who had splenectomy prior to pregnancy had uneventful antenatal and postnatal period.
CONCLUSION: A multidisciplinary approach should be followed in pregnant women with EHPVO. We should be vigilant about risk of variceal bleeding which is a life-threatening complication of EHPVO. Splenectomy prior to pregnancy might lower the risk of maternal and fetal morbidity and help to achieve favourable outcomes.