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Informative Article | Medical Science | India | Volume 12 Issue 4, April 2023
Portal Hypertension in Pregnancy
Dr. Sohini Burman
Abstract: Even though pregnancy is rare with cirrhosis and advanced liver disease, but it may co-exist in the setting of non-cirrhotic portal hypertension as liver function is preserved but whenever encountered together is a complex clinical dilemma. Pregnancy in a patient with portal hypertension presents a special challenge to the obstetrician as so-called physiological hemodynamic changes associated with pregnancy, needed for meeting demands of the growing foetus, worsen the portal hypertension thereby putting mother at risk of potentially life-threatening complications like variceal haemorrhage. Risks of variceal bleed and hepatic decompensation increase many fold during pregnancy. Optimal management revolves round managing the portal hypertension and its complications. Thus management of such cases requires multi-speciality approach involving obstetricians experienced in dealing with high risk cases, hepatologists, anaesthetists and neonatologists. With advancement in medical field, pregnancy is not contra-indicated in these women, as was previously believed. This article focuses on the different aspects of pregnancy with portal hypertension with special emphasis on specific cause wise treatment options to decrease the variceal bleed and hepatic decompensation. Based on extensive review of literature, management from pre-conceptional period to postpartum is outlined in order to have optimal maternal and perinatal outcomes.
Keywords: Portal Hypertension, cirrhosis, variceal bleed, endoscopic variceal ligation, postpartum haemorrhage
Edition: Volume 12 Issue 4, April 2023,
Pages: 1381 - 1382