Maternal and Perinatal Outcome in a Contemporary Cohort of Patients with Portal Hypertension: A Single-Center Experience
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Mauro, E.; Gadano, A. What’s new in portal hypertension? Liver Int. 2020, 40 (Suppl. 1), 122–127. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Lopez-Mendez, E.; Avila-Escobedo, L. Pregnancy and portal hypertension a pathology view of physiologic changes. Ann. Hepatol. 2006, 5, 219–223. [Google Scholar] [CrossRef]
- Russell, M.A.; Craigo, S.D. Cirrhosis and portal hypertension in pregnancy. Semin. Perinatol. 1998, 22, 156–165. [Google Scholar] [CrossRef] [PubMed]
- Hagstrom, H.; Hoijer, J.; Marschall, H.U.; Williamson, C.; Heneghan, M.A.; Westbrook, R.H.; Ludvigsson, J.F.; Stephansson, O. Outcomes of Pregnancy in Mothers With Cirrhosis: A National Population-Based Cohort Study of 1.3 Million Pregnancies. Hepatol. Commun. 2018, 2, 1299–1305. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Shaheen, A.A.; Myers, R.P. The outcomes of pregnancy in patients with cirrhosis: A population-based study. Liver Int. 2010, 30, 275–283. [Google Scholar] [CrossRef] [PubMed]
- Kochhar, R.; Kumar, S.; Goel, R.C.; Sriram, P.V.; Goenka, M.K.; Singh, K. Pregnancy and its outcome in patients with noncirrhotic portal hypertension. Dig. Dis. Sci. 1999, 44, 1356–1361. [Google Scholar] [CrossRef] [PubMed]
- Pajor, A.; Lehoczky, D. Pregnancy and extrahepatic portal hypertension. Review and report on the management. Gynecol. Obstet. Investig. 1990, 30, 193–197. [Google Scholar] [CrossRef]
- Pal, K.; Sadanandan, D.M.; Gupta, A.; Nayak, D.; Pyakurel, M.; Keepanasseril, A.; Maurya, D.K.; Nair, N.S.; Keepanasseril, A. Maternal and perinatal outcome in pregnancies complicated with portal hypertension: A systematic review and meta-analysis. Hepatol. Int. 2023, 17, 170–179. [Google Scholar] [CrossRef]
- Brady, C.W. Liver Disease in Pregnancy: What’s New. Hepatol. Commun. 2020, 4, 145–156. [Google Scholar] [CrossRef][Green Version]
- Joshi, D.; James, A.; Quaglia, A.; Westbrook, R.H.; Heneghan, M.A. Liver disease in pregnancy. Lancet 2010, 375, 594–605. [Google Scholar] [CrossRef]
- Aggarwal, N.; Negi, N.; Aggarwal, A.; Bodh, V.; Dhiman, R.K. Pregnancy with portal hypertension. J. Clin. Exp. Hepatol. 2014, 4, 163–171. [Google Scholar] [CrossRef][Green Version]
- Flemming, J.A.; Mullin, M.; Lu, J.; Sarkar, M.A.; Djerboua, M.; Velez, M.P.; Brogly, S.; Terrault, N.A. Outcomes of Pregnant Women with Cirrhosis and Their Infants in a Population-Based Study. Gastroenterology 2020, 159, 1752–1762.e10. [Google Scholar] [CrossRef]
- Sumana, G.; Dadhwal, V.; Deka, D.; Mittal, S. Non-cirrhotic portal hypertension and pregnancy outcome. J. Obstet. Gynaecol. Res. 2008, 34, 801–804. [Google Scholar] [CrossRef] [PubMed]
- Gala, A.R.; Surapaneni, T.; Aziz, N.; Kallur, S.D. A Review of Outcomes in Pregnant Women with Portal Hypertension. J. Obstet. Gynaecol. India 2018, 68, 447–451. [Google Scholar] [CrossRef]
- Rahim, M.N.; Pirani, T.; Williamson, C.; Heneghan, M.A. Management of pregnancy in women with cirrhosis. United Eur. Gastroenterol. J. 2021, 9, 110–119. [Google Scholar] [CrossRef] [PubMed]
- Gonsalkorala, E.S.; Cannon, M.D.; Lim, T.Y.; Penna, L.; Willliamson, C.; Heneghan, M.A. Non-Invasive Markers (ALBI and APRI) Predict Pregnancy Outcomes in Women with Chronic Liver Disease. Am. J. Gastroenterol. 2019, 114, 267–275. [Google Scholar] [CrossRef]
- Andrade, F.; Shukla, A.; Bureau, C.; Senzolo, M.; D’Alteroche, L.; Heurgue, A.; Garcia-Pagan, J.C.; Turon, F.; Oberti, F.; Tripathi, D.; et al. Pregnancy in idiopathic non-cirrhotic portal hypertension: A multicentric study on maternal and fetal management and outcome. J. Hepatol. 2018, 69, 1242–1249. [Google Scholar] [CrossRef]
- Khan, F.; Rowe, I.; Martin, B.; Knox, E.; Johnston, T.; Elliot, C.; Lester, W.; Chen, F.; Olliff, S.; Mehrzad, H.; et al. Outcomes of pregnancy in patients with known Budd-Chiari syndrome. World J. Hepatol. 2017, 9, 945–952. [Google Scholar] [CrossRef] [PubMed]
- Biswas, S.; Sheikh, S.; Vaishnav, M.; Elhence, A.; Farooqui, N.; Anand, A.; Gamanagatti, S.; Shalimar. Pregnancy outcomes in patients with Budd-Chiari syndrome: A tertiary care experience. Indian J. Gastroenterol. 2023, 42, 96–105. [Google Scholar] [CrossRef]
- Kosian, P.; Ayub, T.; Jansen, C.; Gembruch, U.; Merz, W. Conference Abstract: Maternal and perinatal outcome in patients with portal hypertension: A single-center experience. Z. Geburtshilfe Neonatol. 2021, 225, e66. [Google Scholar] [CrossRef]
- Sarkar, M.; Brady, C.W.; Fleckenstein, J.; Forde, K.A.; Khungar, V.; Molleston, J.P.; Afshar, Y.; Terrault, N.A. Reproductive Health and Liver Disease: Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology 2021, 73, 318–365. [Google Scholar] [CrossRef] [PubMed]
Baseline Characteristics and Outcomes | Cirrhotic Portal Hypertension (n = 5) | Non-Cirrhotic Portal Hypertension (n = 6) | p-Value |
---|---|---|---|
Median thrombocytes G/L | 67 | 161 | 0.08 |
Presence of varices (n) | 4 | 5 | 0.99 |
Median GA at birth (weeks of gestation) | 35 | 37.5 | 0.43 |
Median blood loss (mL) | 900 | 450 | 0.43 |
Mode of delivery | 4 CD, 1 NVD | 4 CD, 1 NVD, 1 instrumental delivery | |
Cases with complications (n) | 4 | 4 | 0.99 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Kosian, P.; Jansen, C.; Chang, J.; Praktiknjo, M.; Ayub, T.H.; Gembruch, U.; Merz, W.M. Maternal and Perinatal Outcome in a Contemporary Cohort of Patients with Portal Hypertension: A Single-Center Experience. J. Clin. Med. 2023, 12, 3088. https://doi.org/10.3390/jcm12093088
Kosian P, Jansen C, Chang J, Praktiknjo M, Ayub TH, Gembruch U, Merz WM. Maternal and Perinatal Outcome in a Contemporary Cohort of Patients with Portal Hypertension: A Single-Center Experience. Journal of Clinical Medicine. 2023; 12(9):3088. https://doi.org/10.3390/jcm12093088
Chicago/Turabian StyleKosian, Philipp, Christian Jansen, Johannes Chang, Michael Praktiknjo, Tiyasha Hosne Ayub, Ulrich Gembruch, and Waltraut M. Merz. 2023. "Maternal and Perinatal Outcome in a Contemporary Cohort of Patients with Portal Hypertension: A Single-Center Experience" Journal of Clinical Medicine 12, no. 9: 3088. https://doi.org/10.3390/jcm12093088
APA StyleKosian, P., Jansen, C., Chang, J., Praktiknjo, M., Ayub, T. H., Gembruch, U., & Merz, W. M. (2023). Maternal and Perinatal Outcome in a Contemporary Cohort of Patients with Portal Hypertension: A Single-Center Experience. Journal of Clinical Medicine, 12(9), 3088. https://doi.org/10.3390/jcm12093088