Document Detail


Pregnancy in Women With Portal Vein Thrombosis: Results of a Multicentric European Study on Maternal and Fetal Management and Outcome.
MedLine Citation:
PMID:  22885716     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Child-bearing aged women account for approximately 25% of patients with non-cirrhotic portal vein thrombosis (PVT). We aimed to assess maternal and fetal outcomein pregnant women with known PVT. Methods: Retrospective analysis of women with chronic PVT's files in three European referral centers between 1986 and 2010. RESULTS: Forty-five pregnancies, 28 (62%) treated with low molecular weight heparin, occurred in 24 women. Nine (20%) were lost before gestation week 20. Preterm birth occurred in 38% of deliveries: there were 3 births at week 24-25, 7 at week 32-36, and 26 after week 37. A term birth with a healthy infant occurred in 58% of pregnancies. Cesarean section was used in 53% of deliveries. Two women developed HELLP syndrome. Favourable outcome happened in 64% of pregnancies. Pregnancies with an unfavorable outcome were associated with higher platelet count at diagnosis. Bleeding from esophageal varices occurred in 3 patients during pregnancy, all without adequate primary prophylaxis. Genital or parietal bleeding occurred postpartum in 4 patients, only one being on anticoagulation therapy. Thrombotic events occurred in 2 patients, none related to lower limbs or mesenteric veins. There were no maternal deaths. CONCLUSION: In pregnant PVT patients treated with anticoagulation on an individual basis, the rate of miscarriage and preterm birth appears to be increased. However, fetal and maternal outcomes are favourable for most pregnancies reaching gestation week 20. High platelet counts appear to increase the risk for unfavourable outcome. Pregnancy should not be contraindicated in stable PVT patients.
Authors:
J Hoekstra; S Seijo; P E Rautou; G Ducarme; L Boudaoud; D Luton; J Alijota; M Casellas-Caro; B Condat; E Bresser; D Thabut; B Larroque; J C Gárcia-Pagán; H L A Janssen; D C Valla; A Plessier
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-7
Journal Detail:
Title:  Journal of hepatology     Volume:  -     ISSN:  0168-8278     ISO Abbreviation:  J. Hepatol.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier B.V.
Affiliation:
Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
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