Pregnancy in women with known and treated Budd-Chiari syndrome: maternal and fetal outcomes.
OBJECTIVE
Budd-Chiari syndrome (BCS) mainly affects women of childbearing age. We aimed to clarify whether pregnancy, a thrombotic risk factor, should be contraindicated in patients with known and treated BCS.


METHODS
A retrospective study of pregnancy in women with known and treated BCS.


RESULTS
Sixteen women had 24 pregnancies. Nine women had undergone surgical or radiological treatment. Anticoagulation was administered during 17 pregnancies. Seven fetuses were lost before gestation week 20. Deliveries occurred between week 20 and 31 in two patients, week 32 and 36 in eleven and after week 37 in four. There was one stillbirth, but 16 infants did well. Factor II gene mutation was a factor for a poor outcome of pregnancies. In two patients, symptomatic thrombosis recurred during pregnancy or postpartum. All patients were alive after a median follow-up of 34 months after the last delivery. Bleeding at delivery, although non-lethal, occurred only on anticoagulation therapy.


CONCLUSIONS
When known and treated BCS is well controlled, pregnancy should not be contraindicated as maternal outcome, and fetal outcome beyond gestation week 20, are good. The risk-benefit ratio of anticoagulant therapy needs to be further clarified. Patients should be fully informed of the persistent risks of such pregnancies.
Rautou
Pierre-Emmanuel
PE
Pôle des Maladies de l'Appareil Digestif, Service d'Hépatologie, Hôpital Beaujon, AP-HP and INSERM U773, Centre de Recherche Biomédicale Bichat Beaujon CRB3, Université Paris 7-Denis-Diderot, Clichy, France.
Angermayr
Bernhard
B
Garcia-Pagan
Juan-Carlos
JC
Moucari
Rami
R
Peck-Radosavljevic
Markus
M
Raffa
Sebastian
S
Bernuau
Jacques
J
Condat
Bertrand
B
Levardon
Michel
M
Yver
Carine
C
Ducarme
Guillaume
G
Luton
Dominique
D
Denninger
Marie-Hélène
MH
Valla
Dominique
D
Plessier
Aurélie
A
D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D006502:Budd-Chiari Syndrome / Q000150:complications* / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
D000925:Anticoagulants