Pregnancy outcomes in women with Budd-Chiari syndrome or portal vein thrombosis A multicentre retrospective cohort study

Hanke M G Wiegers*, Eva N Hamulyák, Stefanie E Damhuis, Jack R van Duuren, Sarwa Darwish Murad, Luuk J J Scheres, Sanne J Gordijn, Jenneke Leentjens, Johannes J Duvekot, Mandy N Lauw, Barbara A Hutten, Saskia Middeldorp, Wessel Ganzevoort

*Bijbehorende auteur voor dit werk

    OnderzoeksoutputAcademicpeer review

    Samenvatting

    OBJECTIVE: To evaluate current practice and outcomes of pregnancy in women previously diagnosed with Budd-Chiari syndrome and/or portal vein thrombosis, with and without concomitant portal hypertension.

    DESIGN AND SETTING: Multicentre retrospective cohort study between 2008-2021.

    POPULATION: Women who conceived in the predefined period after the diagnosis of Budd-Chiari syndrome and/or portal vein thrombosis.

    METHODS AND MAIN OUTCOME MEASURES: We collected data on diagnosis and clinical features. The primary outcomes were maternal mortality and live birth rate. Secondary outcomes included maternal, neonatal and obstetric complications.

    RESULTS: Forty-five women (12 Budd-Chiari syndrome, 33 portal vein thrombosis; 76 pregnancies) were included. Underlying prothrombotic disorders were present in 23 of 45 women (51%). Thirty-eight women (84%) received low-molecular-weight heparin during pregnancy. Of 45 first pregnancies, 11 (24%) ended in pregnancy loss and 34 (76%) resulted in live birth of which 27 at term age (79% of live births and 60% of pregnancies). No maternal deaths were observed, one woman developed pulmonary embolism during pregnancy and two women (4%) had variceal bleeding requiring intervention.

    CONCLUSIONS: The high number of term live births (79%) and lower than expected risk of pregnancy-related maternal and neonatal morbidity in our cohort suggest that Budd-Chiari syndrome and/or portal vein thrombosis should not be considered as an absolute contra-indication for pregnancy. Individualized, nuanced counselling and a multidisciplinary pregnancy surveillance approach are essential in this patient population.

    Originele taal-2English
    TijdschriftBJOG : An International Journal of Obstetrics and Gynaecology
    DOI's
    StatusE-pub ahead of print - 14-sep-2021

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