Maternal–fetal outcome in pregnancies complicated with non-cirrhotic portal hypertension: experience from a Tertiary Centre in South India

Keepanasseril, Anish; Gupta, Avantika; Ramesh, Devika; Kothandaraman, Keerthana; Jeganathan, Yavana Suriya; Maurya, Dilip Kumar

doi:10.1007/s12072-020-10067-5

Cited by 15 publications

(39 citation statements)

References 23 publications

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“…Overall, five studies reported the need for BT due to severe anemia in 237 pregnancies. 16,19,23,25,26 The pooled rate of severe anemia requiring BT was 14.9% (95% CI: 4.2–25.6; I 2 = 80.6%, p = 0.000).…”

Section: Resultsmentioning

confidence: 97%

“…On subgroup analysis, the pooled rate of spontaneous miscarriage was significantly higher in studies from Europe compared to India [21.1% (95% CI: 14.0–28.2) vs. 9.1% (95% CI: 5.4–12.9); p = 0.017]. Comparison of data from three studies 16,17,25 showed no difference in the incidence of spontaneous miscarriage between patients with NCPF and EHPVO (OR 1.25, 95% CI: 0.50–3.13; I 2 = 7%, p = 0.34) (Supplemental Figure 4).…”

Section: Resultsmentioning

confidence: 98%

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Maternal and fetal outcomes in pregnant patients with non-cirrhotic portal hypertension: A systematic review and meta-analysis

et al. 2023

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Background Concerned studies with respect to the outcome of pregnant patients with non-cirrhotic portal hypertension are limited. Thus, a systematic review and meta-analysis of the available literature was conducted. Methods A literature search was conducted from 1999 to December 2021 for studies evaluating pregnancy outcomes in patients with non-cirrhotic portal hypertension. Results Twelve studies were included in the meta-analysis. The pooled rate of variceal bleeding, ascites and severe anemia requiring blood transfusion were 9.6%, 2.3%, and 14.9%, respectively. The pooled rate of spontaneous miscarriage, gestational hypertension, delivery by cesarean section, and postpartum hemorrhage were 11.9%, 4.5%, 36.7%, and 4.7%, respectively. The pooled stillbirth rate was 2.5% and among the live births, the pooled rates of preterm birth, low birth weight, intensive care unit admission, and neonatal mortality were 21.6%, 18.7%, 15.5%, and 1.8%, respectively. Conclusion Pregnancy in patients with non-cirrhotic portal hypertension is associated with increased maternal & fetal morbidity but mortality remains low.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 98%

Maternal and fetal outcomes in pregnant patients with non-cirrhotic portal hypertension: A systematic review and meta-analysis

et al. 2023

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“…Non-cirrhotic portal hypertension is not associated with reduced fertility, in contrast to cirrhotic portal hypertension [26]. Liver function is mostly preserved in non-cirrhotic portal hypertension, therefore the main risks are variceal hemorrhage and hematological complications in the context of hypersplenism [27,28].…”

Section: Discussionmentioning

confidence: 98%

Hepatic cirrhosis with portal hypertension secondary to alpha-1 antitrypsin deficiency and autoimmune hepatitis in pregnancy: A case report

Galibert

O’Rourke

Wolski

et al. 2022

J Case Rep Images Obstet Gynecol

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Introduction: Previously, women with cirrhosis rarely became pregnant due to hypothalamic-pituitary dysfunction. However, with advancements in the care of patients with chronic liver disease, pregnancy is becoming more common in this cohort. We will outline the complex, multidisciplinary approach toward managing an obstetrics patient with portal hypertension in the context of previously decompensated liver cirrhosis. Case Report: A 29-year-old primigravida woman was referred to the Obstetric Medicine Clinic with an unplanned pregnancy at 16 weeks’ gestation. This was on a background of previously decompensated liver cirrhosis and portal hypertension, in the context of alpha-1 antitrypsin deficiency and autoimmune hepatitis. The patient had one upper gastrointestinal bleed at 19 weeks’ gestation and underwent three gastroscopies throughout her pregnancy. At 32+6 weeks gestation, she had an elective lower uterine segment Caesarean Section and delivered a healthy liveborn female. Conclusion: Currently, there are no studies that explore pregnancy outcomes in women with cirrhosis secondary to alpha-1 antitrypsin deficiency. This case describes the pregnancy of a woman with previously decompensated liver cirrhosis and portal hypertension, in the context of alpha-1 antitrypsin deficiency and explores the associated management dilemmas.

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“…[4][5][6][7][9][10][11][12] Neonatal mortality is seen in up to 16% of pregnancies. [4][5][6][7][8][9][10][11]…”

Section: Fetal Outcomesmentioning

confidence: 99%

Pregnancy in Patients with Non-cirrhotic Portal Hypertension: A Literature Review

Giri

Sahoo

2022

Rev Bras Ginecol Obstet

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Pregnancy in non-cirrhotic portal hypertension (NCPH) is an uncommon condition. Its management is challenging both to the obstetricians as well as to the gastroenterologists due to the lack of more extensive studies and standard clinical practice guidelines. These patients are at increased risk of portal hypertension (PTH) complications, especially variceal bleeding, and with an increased incidence of adverse maternal and fetal outcomes. Hence, a multidisciplinary approach is required for management of pregnancy in NCPH. This short review describes the different aspects of pregnancy with NCPH, emphasizing specific strategies for preventing and managing PTH from the preconceptional period to postpartum.

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Maternal–fetal outcome in pregnancies complicated with non-cirrhotic portal hypertension: experience from a Tertiary Centre in South India

Cited by 15 publications

References 23 publications

Maternal and fetal outcomes in pregnant patients with non-cirrhotic portal hypertension: A systematic review and meta-analysis

Maternal and fetal outcomes in pregnant patients with non-cirrhotic portal hypertension: A systematic review and meta-analysis

Hepatic cirrhosis with portal hypertension secondary to alpha-1 antitrypsin deficiency and autoimmune hepatitis in pregnancy: A case report

Pregnancy in Patients with Non-cirrhotic Portal Hypertension: A Literature Review

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