title: Pregnancy in women with portal vein thrombosis: results of a multicentric European study on maternal and fetal management and outcome.
abstract: OBJECTIVE
  Women of childbearing age account for approximately 25% of patients with non-cirrhotic portal vein thrombosis (PVT). We aimed at assessing maternal and fetal outcome in pregnant women with known PVT.
  
  
  METHODS
  We performed a retrospective analysis of the files of women with chronic PVT in three European referral centers between 1986 and 2010.
  
  
  RESULTS
  Forty-five pregnancies, 28 (62%) treated with low molecular weight heparin, occurred in 24 women. Nine (20%) were lost before gestation week 20. Preterm birth occurred in 38% of deliveries: there were 3 births at week 24-25, 7 at week 32-36, and 26 after week 37. A term birth with a healthy infant occurred in 58% of pregnancies. Cesarean section was used in 53% of deliveries. Two women developed HELLP syndrome. A favorable outcome happened in 64% of pregnancies. Pregnancies with an unfavorable outcome were associated with a higher platelet count at diagnosis. Bleeding from esophageal varices occurred in 3 patients during pregnancy, all without adequate primary prophylaxis. Genital or parietal bleeding occurred postpartum in 4 patients, only one being on anticoagulation therapy. Thrombotic events occurred in 2 patients, none related to lower limbs or mesenteric veins. There were no maternal deaths.
  
  
  CONCLUSIONS
  In pregnant PVT patients treated with anticoagulation on an individual basis, the rate of miscarriage and preterm birth appears to be increased. However, fetal and maternal outcomes are favorable for most pregnancies reaching gestation week 20. High platelet counts appear to increase the risk for unfavorable outcome. Pregnancy should not be contraindicated in stable PVT patients.
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Hoekstra
authors.forename: S
authors.initials: S
authors.lastname: Seijo
authors.forename: P E
authors.initials: PE
authors.lastname: Rautou
authors.forename: G
authors.initials: G
authors.lastname: Ducarme
authors.forename: L
authors.initials: L
authors.lastname: Boudaoud
authors.forename: D
authors.initials: D
authors.lastname: Luton
authors.forename: J
authors.initials: J
authors.lastname: Alijotas-Reig
authors.forename: M
authors.initials: M
authors.lastname: Casellas-Caro
authors.forename: B
authors.initials: B
authors.lastname: Condat
authors.forename: E
authors.initials: E
authors.lastname: Bresser
authors.forename: D
authors.initials: D
authors.lastname: Thabut
authors.forename: B
authors.initials: B
authors.lastname: Larroque
authors.forename: J C
authors.initials: JC
authors.lastname: Gárcia-Pagán
authors.forename: H L A
authors.initials: HL
authors.lastname: Janssen
authors.forename: D C
authors.initials: DC
authors.lastname: Valla
authors.forename: A
authors.initials: A
authors.lastname: Plessier
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D011169:Portal Vein; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology; D012189:Retrospective Studies; D020246:Venous Thrombosis / Q000150:complications / Q000188:drug therapy*
chemical_list: D006495:Heparin, Low-Molecular-Weight