Pregnancy and its outcome in patients with noncirrhotic portal hypertension

Rakesh Kochhar, Sanjay Kumar, Ramesh C. Goel, Sreeram Parupudi, Mahesh K. Goenka, Kartar Singh

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

There is paucity of data in the literature on the occurrence of pregnancy and its outcome in patients with noncirrhotic portal hypertension. The present study was undertaken to assess the fertility pattern, fetal loss, and consequences of variceal bleeding during pregnancy in these patients. Fifty-five women of child-bearing age with a diagnosis of noncirrhotic portal hypertension (including 32 with noncirrhotic portal fibrosis and 23 with extrahepatic portal venous obstruction) and 44 age-matched controls were studied. A detailed history of obstetric events and bleeding episodes was recorded in all patients. Any complication of portal hypertension was managed accordingly. Patients were classified into three groups for analysis: group 1 - obstetric events after the diagnosis of portal hypertension in patients; group II - obstetric events before the diagnosis of portal hypertension in patients; and group III - obstetric events in controls. A total of 116 pregnancies took place in 44 patients. Of these, 36 occurred after and 80 before the diagnosis of portal hypertension was made. In the 44 controls, 118 pregnancies took place. The mean fertility rates of groups I, II and III were 0.20 ± 0.24, 0.18 ± 0.21, and 0.22 ± 0.12 pregnancies per year, respectively, which were not statistically different (P > 0.05). The numbers of fetal losses in groups I, II and III were 3/36 (8.3%), 6/80 (7.5%), and 12/118 (10.17%) pregnancies, respectively. Menstrual irregularities were found in 7/55 (12.72%) patients and 6/44 (13.6%) controls (P > 0.05). Five episodes of variceal bleeding occurred in 36 pregnancies after the diagnosis of portal hypertension (13.88%). All five were successfully managed with endoscopic sclerotherapy. In conclusion, noncirrhotic portal hypertensive patients have normal fertility and outcome of pregnancy. Variceal bleeding episodes are not common and endoscopic sclerotherapy is safe and effective in pregnancy.

Original languageEnglish (US)
Pages (from-to)1356-1361
Number of pages6
JournalDigestive Diseases and Sciences
Volume44
Issue number7
DOIs
StatePublished - 1999
Externally publishedYes

Fingerprint

Portal Hypertension
Pregnancy Outcome
Pregnancy
Obstetrics
Hemorrhage
Sclerotherapy
Fertility
Birth Rate
Fibrosis

Keywords

  • Extrahepatic portal vein obstruction
  • Fertility
  • Noncirrhotic portal fibrosis
  • Portal hypertension
  • Pregnancy

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Pregnancy and its outcome in patients with noncirrhotic portal hypertension. / Kochhar, Rakesh; Kumar, Sanjay; Goel, Ramesh C.; Parupudi, Sreeram; Goenka, Mahesh K.; Singh, Kartar.

In: Digestive Diseases and Sciences, Vol. 44, No. 7, 1999, p. 1356-1361.

Research output: Contribution to journalArticle

Kochhar, Rakesh ; Kumar, Sanjay ; Goel, Ramesh C. ; Parupudi, Sreeram ; Goenka, Mahesh K. ; Singh, Kartar. / Pregnancy and its outcome in patients with noncirrhotic portal hypertension. In: Digestive Diseases and Sciences. 1999 ; Vol. 44, No. 7. pp. 1356-1361.
@article{36aad6838fb24d8aa385bd89e8a664db,
title = "Pregnancy and its outcome in patients with noncirrhotic portal hypertension",
abstract = "There is paucity of data in the literature on the occurrence of pregnancy and its outcome in patients with noncirrhotic portal hypertension. The present study was undertaken to assess the fertility pattern, fetal loss, and consequences of variceal bleeding during pregnancy in these patients. Fifty-five women of child-bearing age with a diagnosis of noncirrhotic portal hypertension (including 32 with noncirrhotic portal fibrosis and 23 with extrahepatic portal venous obstruction) and 44 age-matched controls were studied. A detailed history of obstetric events and bleeding episodes was recorded in all patients. Any complication of portal hypertension was managed accordingly. Patients were classified into three groups for analysis: group 1 - obstetric events after the diagnosis of portal hypertension in patients; group II - obstetric events before the diagnosis of portal hypertension in patients; and group III - obstetric events in controls. A total of 116 pregnancies took place in 44 patients. Of these, 36 occurred after and 80 before the diagnosis of portal hypertension was made. In the 44 controls, 118 pregnancies took place. The mean fertility rates of groups I, II and III were 0.20 ± 0.24, 0.18 ± 0.21, and 0.22 ± 0.12 pregnancies per year, respectively, which were not statistically different (P > 0.05). The numbers of fetal losses in groups I, II and III were 3/36 (8.3{\%}), 6/80 (7.5{\%}), and 12/118 (10.17{\%}) pregnancies, respectively. Menstrual irregularities were found in 7/55 (12.72{\%}) patients and 6/44 (13.6{\%}) controls (P > 0.05). Five episodes of variceal bleeding occurred in 36 pregnancies after the diagnosis of portal hypertension (13.88{\%}). All five were successfully managed with endoscopic sclerotherapy. In conclusion, noncirrhotic portal hypertensive patients have normal fertility and outcome of pregnancy. Variceal bleeding episodes are not common and endoscopic sclerotherapy is safe and effective in pregnancy.",
keywords = "Extrahepatic portal vein obstruction, Fertility, Noncirrhotic portal fibrosis, Portal hypertension, Pregnancy",
author = "Rakesh Kochhar and Sanjay Kumar and Goel, {Ramesh C.} and Sreeram Parupudi and Goenka, {Mahesh K.} and Kartar Singh",
year = "1999",
doi = "10.1023/A:1026687315590",
language = "English (US)",
volume = "44",
pages = "1356--1361",
journal = "Digestive Diseases and Sciences",
issn = "0163-2116",
publisher = "Springer New York",
number = "7",

}

TY - JOUR

T1 - Pregnancy and its outcome in patients with noncirrhotic portal hypertension

AU - Kochhar, Rakesh

AU - Kumar, Sanjay

AU - Goel, Ramesh C.

AU - Parupudi, Sreeram

AU - Goenka, Mahesh K.

AU - Singh, Kartar

PY - 1999

Y1 - 1999

N2 - There is paucity of data in the literature on the occurrence of pregnancy and its outcome in patients with noncirrhotic portal hypertension. The present study was undertaken to assess the fertility pattern, fetal loss, and consequences of variceal bleeding during pregnancy in these patients. Fifty-five women of child-bearing age with a diagnosis of noncirrhotic portal hypertension (including 32 with noncirrhotic portal fibrosis and 23 with extrahepatic portal venous obstruction) and 44 age-matched controls were studied. A detailed history of obstetric events and bleeding episodes was recorded in all patients. Any complication of portal hypertension was managed accordingly. Patients were classified into three groups for analysis: group 1 - obstetric events after the diagnosis of portal hypertension in patients; group II - obstetric events before the diagnosis of portal hypertension in patients; and group III - obstetric events in controls. A total of 116 pregnancies took place in 44 patients. Of these, 36 occurred after and 80 before the diagnosis of portal hypertension was made. In the 44 controls, 118 pregnancies took place. The mean fertility rates of groups I, II and III were 0.20 ± 0.24, 0.18 ± 0.21, and 0.22 ± 0.12 pregnancies per year, respectively, which were not statistically different (P > 0.05). The numbers of fetal losses in groups I, II and III were 3/36 (8.3%), 6/80 (7.5%), and 12/118 (10.17%) pregnancies, respectively. Menstrual irregularities were found in 7/55 (12.72%) patients and 6/44 (13.6%) controls (P > 0.05). Five episodes of variceal bleeding occurred in 36 pregnancies after the diagnosis of portal hypertension (13.88%). All five were successfully managed with endoscopic sclerotherapy. In conclusion, noncirrhotic portal hypertensive patients have normal fertility and outcome of pregnancy. Variceal bleeding episodes are not common and endoscopic sclerotherapy is safe and effective in pregnancy.

AB - There is paucity of data in the literature on the occurrence of pregnancy and its outcome in patients with noncirrhotic portal hypertension. The present study was undertaken to assess the fertility pattern, fetal loss, and consequences of variceal bleeding during pregnancy in these patients. Fifty-five women of child-bearing age with a diagnosis of noncirrhotic portal hypertension (including 32 with noncirrhotic portal fibrosis and 23 with extrahepatic portal venous obstruction) and 44 age-matched controls were studied. A detailed history of obstetric events and bleeding episodes was recorded in all patients. Any complication of portal hypertension was managed accordingly. Patients were classified into three groups for analysis: group 1 - obstetric events after the diagnosis of portal hypertension in patients; group II - obstetric events before the diagnosis of portal hypertension in patients; and group III - obstetric events in controls. A total of 116 pregnancies took place in 44 patients. Of these, 36 occurred after and 80 before the diagnosis of portal hypertension was made. In the 44 controls, 118 pregnancies took place. The mean fertility rates of groups I, II and III were 0.20 ± 0.24, 0.18 ± 0.21, and 0.22 ± 0.12 pregnancies per year, respectively, which were not statistically different (P > 0.05). The numbers of fetal losses in groups I, II and III were 3/36 (8.3%), 6/80 (7.5%), and 12/118 (10.17%) pregnancies, respectively. Menstrual irregularities were found in 7/55 (12.72%) patients and 6/44 (13.6%) controls (P > 0.05). Five episodes of variceal bleeding occurred in 36 pregnancies after the diagnosis of portal hypertension (13.88%). All five were successfully managed with endoscopic sclerotherapy. In conclusion, noncirrhotic portal hypertensive patients have normal fertility and outcome of pregnancy. Variceal bleeding episodes are not common and endoscopic sclerotherapy is safe and effective in pregnancy.

KW - Extrahepatic portal vein obstruction

KW - Fertility

KW - Noncirrhotic portal fibrosis

KW - Portal hypertension

KW - Pregnancy

UR - http://www.scopus.com/inward/record.url?scp=0032815713&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032815713&partnerID=8YFLogxK

U2 - 10.1023/A:1026687315590

DO - 10.1023/A:1026687315590

M3 - Article

C2 - 10489918

AN - SCOPUS:0032815713

VL - 44

SP - 1356

EP - 1361

JO - Digestive Diseases and Sciences

JF - Digestive Diseases and Sciences

SN - 0163-2116

IS - 7

ER -