Massive bleeding in pregnancy from ruptured oesophageal varices complicating portal hypertension: a cautionary tale

Crocker, Alison; Girling, Joanna; Cotzias, Christina

doi:10.1258/om.2011.100075

Cited by 4 publications

(2 citation statements)

References 12 publications

(11 reference statements)

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“…Splenic artery aneurysm rupture has been reported to occur in 2.6% of all pregnancies with cirrhosis with a high maternal mortality rate of 70% and fetal mortality rate of 90%. Considering the fact that this is associated with high mortality rates, clinicians must consider ruptured splenic artery aneurysm if a woman presents with acute abdomen or hypotensive shock that is unexplainable or there is a sudden maternal collapse [6,7,[14][15][16].…”

Section: Discussionmentioning

confidence: 99%

A Review of Outcomes in Pregnant Women with Portal Hypertension

Gala

Surapaneni

Aziz

et al. 2017

J Obstet Gynecol India

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Background The course of pregnancy in a woman with portal hypertension is a difficult one as it is associated with complications like variceal bleeding, splenic artery rupture and coagulopathy. All these pose a threat to a woman's life. Although this condition is rare, every obstetrician should have a high index of suspicion when an antenatal mother presents with splenomegaly, thrombocytopenia or hematemesis. Hence, we aimed to review maternal and fetal outcomes in pregnant women with portal hypertension. Methods In a retrospective observational study, 41 women and 47 pregnancies were evaluated, from January 2000-December 2015 at Fernandez Hospital, a tertiary referral perinatal center. Maternal outcomes studied were variceal bleed during pregnancy, surgical procedures, morbidity and

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Section: Discussionmentioning

confidence: 99%

A Review of Outcomes in Pregnant Women with Portal Hypertension

Gala

Surapaneni

Aziz

et al. 2017

J Obstet Gynecol India

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show abstract

“…[18,19]. Іншими можливими ускладненнями ПГ при вагітності є розрив аневризми селезінкової артерії (виникає у 2,6% усіх вагітних з ЦП і часто призводить до материнської та перинатальної смертності) [20][21][22], коагулопатія, печінкова недостатність [23], що найчастіше виникає після кровотечі з ВРВ стравоходу та шлунка [24].…”

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Portal Hypertension and Pregnancy

ISLAMOVA¹,

MEDVED²,

KYRYLCHUK³

et al. 2022

AAGU

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Portal hypertension (PH) is a pathological condition characterized by a persistent increase in pressure in the portal vein pool (>10 mmHg) caused by blood circulation blockage at various levels of the portal system. PH is accompanied by the varicose veins development (VV) of the esophagus and stomach. With the progression of the main disease, severe complications of PH occur (bleeding from varicose veins of the esophagus and stomach, liver failure). The combination of PH and pregnancy is a serious problem in practical obstetrics. This article is devoted to a review of the literature on the issues of PH and pregnancy. The classifications of PH, VV of the esophagus and stomach are considered. Modern views on the possibility of carrying a pregnancy with PH, on the peculiarities of the course of pregnancy, childbirth and the postpartum period are given. Also about the tactics of managing gestation, methods and terms of childbirth, risks of developing complications of PH and pregnancy, treatment of PH and its complications

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Splenic artery aneurysm rupture in a pregnant woman with hepatosplenic schistosomiasis: case report and literature review

Razafindrazoto,

Randrianiaina,

Ralaizanaka

et al. 2024

Egypt Liver Journal

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Background Pregnancy is not uncommon in patients with non-cirrhotic portal hypertension. Rupture of a splenic artery aneurysm remains a rare complication, associated with a very poor maternal–fetal prognosis. Our aim is to report a case of ruptured splenic aneurysm and to show the maternal–fetal over-risks during the association of pregnancy and portal hypertension, even in non-cirrhotic patients. Case presentation We report a case of a 34-year-old woman, pregnant at 24 weeks gestation, with non-cirrhotic portal hypertension due to hepatic schistosomiasis. She was hospitalized for variceal bleeding. Patient had undergone endoscopic variceal band ligation and no bleeding recurrence. An unexplained hypovolemic shock appeared during the hospitalization with the occurrence of an in utero fetal death. The fetus was delivered by vaginal delivery. Abdominal CT scan angiogram showed a splenic artery aneurysm rupture. The patient underwent an emergency laparotomy with ligation of the splenic artery associated with splenectomy. Postoperative course was simple. Management of portal hypertension was continued at discharge (diuretic, beta-blockers, and esophageal varices ligation). Conclusion The association of pregnancy and portal hypertension remains a serious situation with a high risk of maternal–fetal complications. Splenic artery aneurysm rupture is one of the rare complications of this association with a very poor maternal–fetal prognosis. Open repair is the surgical treatment of choice with a non-negligible morbi-mortality.

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Massive bleeding in pregnancy from ruptured oesophageal varices complicating portal hypertension: a cautionary tale

Cited by 4 publications

References 12 publications

A Review of Outcomes in Pregnant Women with Portal Hypertension

A Review of Outcomes in Pregnant Women with Portal Hypertension

Portal Hypertension and Pregnancy

Splenic artery aneurysm rupture in a pregnant woman with hepatosplenic schistosomiasis: case report and literature review

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