Portal hypertension in a pregnant woman.
We report a case of a patient with long-standing prehepatic portal hypertension. The patient (a 43-year-old parous 2012 female with a history of 2 full-term pregnancies and normal deliveries, plus a spontaneous abortion) incurred spontaneous abortion at the 7th week of gestation. An early, spontaneous abortion avoided this patient running severe risks in late pregnancy. The overall estimated risk of bleeding in patients with portal hypertension, reported in the literature, is 400 times greater than in normal pregnancy. The association with aneurysm of splenic artery increases the likelihood of bleeding because intra-abdominal pressure adds to the risk of rupture of the aneurysms. In our opinion, a patient of fertile age, with pre-hepatic hypertension and associated chronic liver disease, should be treated with contraceptives to avoid any pregnancy-induced risk of complications.
Paternoster
D M
DM
Department of Gastroenterology, University of Padua, Italy.
Floreani
A R
AR
Paggioro
A
A
Laureti
E
E
D000328:Adult; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D012307:Risk Factors; D015911:Sclerotherapy