Abstract
References
- 1. Sarin SK, Kapoor D. Non-cirrhotic portal fibrosis: current concepts and management. J GastroenterolHepatol 2002; 17: 526–534.
- 2. Okuda K. Non-cirrhotic portal hypertension: why is it so common in India? J Gastroenterol Hepatol 2002; 17: 1–5.
- 3. Benhamou JP, Valla DC. Intrahepatic portal hypertension. In: Bircher J, Benhamou JP, McIntyre N, et al, eds. Oxford Textbook of Clinical Hepatology. 2nd ed.Oxford: Oxford University Press, 1999. p.661–670.
- 4. Shaheen A A, Mayers RP. The outcomes of pregnancy in patients with cirrhosis: a population-based study. Liver Int 2010;30: 275-283.
- 5. Britton RC. Pregnancy and esophageal varices. Am J Surg 1982;143:421-425. 6. Pajor A, Lehoczky D. Pregnancy and extrahepatic portal hypertension. Gynecol Obstet Invest 1990;30: 193-197.
- 7. Tan J, Surti B, Saab S. Pregnancy and cirrhosis. Liver Transpl 2008;14: 1081-1091.
- 8. Starkel P, Horsmans Y, Geubel A. Endoscopic band ligation: a safe technique to control bleeding esophageal varices in pregnancy. Gastrointest Endosc 1998;48: 212-214.
- 9. Misra S, Sanyal AJ. Pregnancy in a patient with portal hypertension. Clin Liver Dis 1999;3: 147-162.
Abstract
Objective: We aimed to revise the pregnancy and
portal hypertension approach which is rarely seen together and may cause
bleeding in esophageal varices.
Case Report: A 35-year-old patient with portal
hypertension at 38 weeks of gestation according to first trimestr
ultrasonography (USG) was admitted to our clinic. At the age of 16, she was
diagnosed with liver biopsy. She had had two vaginal births before. The patient
did not have 2nd and 3rd trimester screening tests. The detailed USG was
normal. The abdominal USG had a liver size of 14.5 cm. Hepatic venules and
portal venous diameter were 8.2 mm at the level of the liver hilus. Spleen size
was 14.5 cm. In the vicinity of the splenic hilus, the widest 13 mm diameter
tortuous veins were observed. A council consisting of Gynecology,
Gastroenterology and Neonatology team at 32nd week of pregnancy it was
suggested that clinical and laboratory findings were closely followed and
vaginal delivery was recommended unless there was an obstetric problem. The
pregnancy was terminated by cesarean section because acute fetal distress
developed when she was followed on the travay when she applied at 38th
gestational week. Meconium 2420 gr 48 cm Apgar score 6/8 male baby was born.
Conclusions: Portal
hypertension is defined as elevation of blood pressure in the portal vein and
its branches over 200-230 mmH2O. Portal hypertension and pregnancy can rarely
be confronted. It increases the mortality and morbidity of the baby and the mother.
Portal hypertension does not constitute a contraindication to pregnancy. During
pregnancy, esophageal variceal bleeding, premature delivery, intrauterine
growth restriction and fetal death can occur. In our case, we had a baby born
with low birth weight who had cesarean section for an obstetric cause. As a
result, the management of complications caused by portal hypertension during
pregnancy is similar to that in non-pregnant patients, but a more intensive
monitoring and follow-up is necessary.
References
- 1. Sarin SK, Kapoor D. Non-cirrhotic portal fibrosis: current concepts and management. J GastroenterolHepatol 2002; 17: 526–534.
- 2. Okuda K. Non-cirrhotic portal hypertension: why is it so common in India? J Gastroenterol Hepatol 2002; 17: 1–5.
- 3. Benhamou JP, Valla DC. Intrahepatic portal hypertension. In: Bircher J, Benhamou JP, McIntyre N, et al, eds. Oxford Textbook of Clinical Hepatology. 2nd ed.Oxford: Oxford University Press, 1999. p.661–670.
- 4. Shaheen A A, Mayers RP. The outcomes of pregnancy in patients with cirrhosis: a population-based study. Liver Int 2010;30: 275-283.
- 5. Britton RC. Pregnancy and esophageal varices. Am J Surg 1982;143:421-425. 6. Pajor A, Lehoczky D. Pregnancy and extrahepatic portal hypertension. Gynecol Obstet Invest 1990;30: 193-197.
- 7. Tan J, Surti B, Saab S. Pregnancy and cirrhosis. Liver Transpl 2008;14: 1081-1091.
- 8. Starkel P, Horsmans Y, Geubel A. Endoscopic band ligation: a safe technique to control bleeding esophageal varices in pregnancy. Gastrointest Endosc 1998;48: 212-214.
- 9. Misra S, Sanyal AJ. Pregnancy in a patient with portal hypertension. Clin Liver Dis 1999;3: 147-162.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Case Reports |
| Authors | |
| Publication Date | June 30, 2019 |
| Acceptance Date | June 29, 2019 |
| Published in Issue | Year 2019 |