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PREGNANCY AND DELIVERY IN WOMEN WITH ESOPHAGEAL VARICES DUE TO HEPATIC VEIN TROMBOSIS.
MedLine Citation:
PMID:  24670239     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Material: From 2000 to 2012 seven pregnant were admitted. None had Ltx, the varicose have been in the 1st stage. Each of them has been consulted by the obstetrician, transplant surgeon and anesthetist. The patient condition during pregnancy, labor and postpartum period was analyzed.Results: Pregnancy in 5 cases proceeded physiologically. In 1 threatening miscarriage was diagnosed and treated with gestagens, two patients had tocolityc. One required variceal banding twice. In 3 thrombocytopenia worsened, with platelet count 70g/L(up to 59g/L). They received platelet transfusion before delivery. In one case significant hipoproteinemia (4.7g/L) occurred. In 1 case GDM G1 and oligohydramnios were found. All women delivered at term (37-40Hbd). In all general anesthesia with use of remifentanil was done. There was no fluctuations in MAP and HR. Incision to delivery time was 2.5min. Time from opioid administration to birth was <4min. All children were born in good condition, weight 10-90percentil.Regional anesthesia is contraindicated in patients with thrombocytopenia. In patients with esophageal varices sudden increase in heart rate and blood pressure can cause hemorrhage.Conclusion: Patients with portal hypertension can deliver at term. It is a high risk pregnancy. In this group it is desirable to shorten the second stage of labor or complete it by c-section under general anesthesia with remifentanyl which allows to get desired analgesia without complications in the newborn. Surveillance of pregnant with portal hypertension must include monitoring of liver function and coagulation disorders.
Authors:
Z Jabiry-Zieniewicz; Fa Dabrowski; B Suchońska; R Kowalczyk; E Nowacka; B Kociszewska-Najman; B Pietrzak; P Malkowski; M Wielgos
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-3-27
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  -     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2014 Mar 
Date Detail:
Created Date:  2014-3-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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