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BJOG : an international journal of obstetrics and gynaecology · 2026

Complications of Pregnancy and Birth in Women With Vascular Malformations: A Nationwide Cross-Sectional Study.

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de Oliveira Marreiros Delano J, Lokhorst Max M, Horbach Sophie E R, Stor Merel L E, van Hout Naomi, Gerdes Victor E A, Ganzevoort Wessel, van der Horst Chantal M A M

Аннотация

OBJECTIVE: To investigate risks of pregnancy and birth in patients with peripheral vascular malformations (VMs).

DESIGN: Nationwide cross-sectional study.

SETTING: Tertiary referral centre and Dutch national patient organisation.

POPULATION: Women aged ≥ 15 years diagnosed with peripheral VM of any subtype or anatomical location.

METHODS: Patients were invited to complete a comprehensive questionnaire about obstetric history and VM-related symptoms during pregnancy.

MAIN OUTCOME MEASURES: Prevalence of complications, specifically worsening of VM-related symptoms during pregnancy, deep venous thrombosis (DVT), pulmonary embolism (PE) and postpartum haemorrhage (PPH).

RESULTS: Two-hundred-six women completed the questionnaire. Among 108 patients, 248 pregnancies and 204 births were reported; 98 patients were nulligravid. DVT and PE occurred in 2.5% and 0.5% of total pregnancies, respectively and only occurred in patients with extensive VMs (> 30 cm) involving at least the lower extremities (predominantly Klippel-Trenaunay). PPH occurred in 19.6% of births, including in 63.6% of those with uterine involvement and 47.8% with genital involvement of the VM. VM-related symptom worsening and volume increase during pregnancy occurred in 47.6% and 45.4% of patients, respectively. In multivariable regression, AVM subtype (OR 4.0, 95% CI 1.0-15.1), genital region involvement (OR 4.6, 95% CI 1.5-13.8), and a history of puberty-related symptom progression (OR 2.6, 95% CI 1.1-6.2) were independently associated with VM-related symptom worsening during pregnancy.

CONCLUSIONS: Women with VMs appear to have a significant risk of PPH and worsening of VM-related symptoms during pregnancy, especially if the genital region is involved. Increased thromboembolic risk appears confined to patients with extensive VMs involving the lower extremities.

Предметные рубрики MeSH

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

Реквизиты и контакты