| Popis: |
There is paucity of data in the literature onthe occurrence of pregnancy and its outcome in patientswith noncirrhotic portal hypertension. The present studywas undertaken to assess the fertility pattern, fetal loss, and consequences of varicealbleeding during pregnancy in these patients. Fifty-fivewomen of child-bearing age with a diagnosis ofnoncirrhotic portal hypertension (including 32 withnoncirrhotic portal fibrosis and 23 with extrahepatic portalvenous obstruction) and 44 age-matched controls werestudied. A detailed history of obstetric events andbleeding episodes was recorded in all patients. Any complication of portal hypertension was managedaccordingly. Patients were classified into three groupsfor analysis: group 1-obstetric events after thediagnosis of portal hypertension in patients; group II-obstetric events before the diagnosis ofportal hypertension in patients; and group III-obstetricevents in controls. A total of 116 pregnancies tookplace in 44 patients. Of these, 36 occurred after and 80 before the diagnosis of portalhypertension was made. In the 44 controls, 118pregnancies took place. The mean fertility rates ofgroups I, II and III were 0.20 ± 0.24, 0.18± 0.21, and 0.22 ± 0.12 pregnancies per year,respectively, which were not statistically different (P> 0.05). The numbers of fetal losses in groups I, IIand III were 3/36 (8.3%), 6/80 (7.5%), and 12/118(10.17%) pregnancies, respectively. Menstrualirregularities were found in 7/55 (12.72%) patients and6/44 (13.6%) controls (P > 0.05). Five episodes ofvariceal bleeding occurred in 36 pregnancies after the diagnosis of portal hypertension (13.88%). Allfive were successfully managed with endoscopicsclerotherapy. In conclusion, noncirrhotic portalhypertensive patients have normal fertility and outcomeof pregnancy. Variceal bleeding episodes are notcommon and endoscopic sclerotherapy is safe andeffective in pregnancy. |
Full text from SpringerLink