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Abstract Details
Portal hypertension in pregnancy - Concealed perils
Obstet Med. 2020 Sep;13(3):142-144. doi: 10.1177/1753495X18801464. Epub 2018 Dec 4.
Adam Morton1, Josephine Laurie1, Jessica Hill1
Author information
1Mater Health and University of Queensland, Brisbane, Australia.
Abstract
Pregnancy in women with portal hypertension is high risk due to the danger of variceal haemorrhage, which complicates 15-34% of cases. Variceal bleeding in pregnancy to women with non-cirrhotic portal hypertension is associated with increased risk of abortion (29%) and perinatal death (33%). Pregnancy in women with cirrhosis while less common due to hypogonadism, is associated with additional potential complications of hepatic decompensation and encephalopathy (10%), hepatorenal syndrome, ascites and bacterial peritonitis. Pregnancy in women with cirrhotic portal hypertension is associated with maternal death in 1.6%, and fetal loss in 10-66%. We present a case of non-cirrhotic portal hypertension in pregnancy, discussing two other potential critical complications of portal hypertension in pregnancy, splenic artery aneurysm (SAA) and pulmonary hypertension.