Maternal-fetal outcome in pregnancies complicated with non-cirrhotic portal hypertension: experience from a Tertiary Centre in South India.
Anish KeepanasserilAvantika GuptaDevika RameshKeerthana KothandaramanYavana Suriya JeganathanDilip Kumar MauryaPublished in: Hepatology international (2020)
During the study period, portal hypertension was noted in 0.07%(n = 108) of the pregnancies and 74.1% of them had NCPH. The diagnosis was made for the first time in 54.7% of them when presented with pancytopenia or splenomegaly. Variceal bleeding complicated 25% of the pregnancies in women with NCPH pregnancies, with three among them having a massive bleed. Eighteen among them underwent endoscopy following bleeding; variceal banding procedure was performed in nine of them without any complications. Preterm birth was the most common (20.6%) obstetric complication. There was one maternal death from severe sepsis, acute kidney injury, and disseminated intravascular coagulation, following a massive variceal bleed. Obstetric outcomes and medical complications were similar in women with NCPF and EHPVO. Perinatal loss was comparable in both the groups (14.3% vs. 9.6%, p = 0.417) CONCLUSION: Multidisciplinary team approach, with optimal and timely intervention with intensive monitoring, can reduce the morbidity and help achieve an optimal maternal-perinatal outcome in pregnancies complicated with portal hypertension.
Keyphrases
- preterm birth
- gestational age
- birth weight
- pregnancy outcomes
- pregnant women
- blood pressure
- acute kidney injury
- low birth weight
- atrial fibrillation
- randomized controlled trial
- cardiac surgery
- risk factors
- intensive care unit
- coronary artery
- palliative care
- type diabetes
- body mass index
- minimally invasive
- skeletal muscle
- preterm infants
- physical activity
- metabolic syndrome
- small bowel
- glycemic control