Cavernous transformation of the portal vein complicating pregnancy.
BACKGROUND
Cavernous transformation of the portal vein, associated with varices and thrombocytopenia, rarely complicates pregnancy.


METHODS
A 20-year-old primigravida with cavernous transformation of the portal vein underwent wireless video esophageal capsule endoscopy at 28 weeks of gestation, which ruled out esophageal and gastric varices and the need for prophylactic sclerotherapy. Magnetic resonance angiography at 32 weeks of gestation showed no abdominal wall varices or abnormally dilated lumbar or extradural veins, which ensured a safe surgical approach for cesarean and preserved the patient's ability to receive regional anesthesia.


CONCLUSIONS
New noninvasive imaging modalities aided evaluation and management of the gravida with cavernous transformation of the portal vein.
Wax
Joseph R
JR
Division of Maternal & Fetal Medicine, Department of Obstetrics and Gynecology, Maine Medical Center, Portland, ME 04102, USA. waxj@mmc.org
Pinette
Michael G
MG
Cartin
Angelina
A
Winn
Steven S
SS
Blackstone
Jacquelyn
J
D000328:Adult; D002585:Cesarean Section; D016145:Endoscopy, Digestive System; D004932:Esophageal and Gastric Varices / Q000150:complications; D005260:Female; D005865:Gestational Age; D006801:Humans; D006971:Hypersplenism / Q000150:complications; D006975:Hypertension, Portal / Q000150:complications; D016239:MEDLINE; D008279:Magnetic Resonance Imaging; D011169:Portal Vein / Q000002:abnormalities*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis*; D013921:Thrombocytopenia / Q000150:complications; D014470:Umbilical Cord; D020246:Venous Thrombosis / Q000150:complications