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Pregnancy outcomes in women with Budd–Chiari syndrome or portal vein thrombosis – a multicentre retrospective cohort study

OBJECTIVE: To evaluate current practice and outcomes of pregnancy in women previously diagnosed with Budd–Chiari syndrome and/or portal vein thrombosis, with and without concomitant portal hypertension. DESIGN AND SETTING: Multicentre retrospective cohort study between 2008 and 2021. POPULATION: Wom...

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Autores principales: Wiegers, HMG, Hamulyák, EN, Damhuis, SE, van Duuren, JR, Darwish Murad, S, Scheres, LJJ, Gordijn, SJ, Leentjens, J, Duvekot, JJ, Lauw, MN, Hutten, BA, Middeldorp, S, Ganzevoort, W
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9293458/
https://www.ncbi.nlm.nih.gov/pubmed/34520620
http://dx.doi.org/10.1111/1471-0528.16915
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author Wiegers, HMG
Hamulyák, EN
Damhuis, SE
van Duuren, JR
Darwish Murad, S
Scheres, LJJ
Gordijn, SJ
Leentjens, J
Duvekot, JJ
Lauw, MN
Hutten, BA
Middeldorp, S
Ganzevoort, W
author_facet Wiegers, HMG
Hamulyák, EN
Damhuis, SE
van Duuren, JR
Darwish Murad, S
Scheres, LJJ
Gordijn, SJ
Leentjens, J
Duvekot, JJ
Lauw, MN
Hutten, BA
Middeldorp, S
Ganzevoort, W
author_sort Wiegers, HMG
collection PubMed
description OBJECTIVE: To evaluate current practice and outcomes of pregnancy in women previously diagnosed with Budd–Chiari syndrome and/or portal vein thrombosis, with and without concomitant portal hypertension. DESIGN AND SETTING: Multicentre retrospective cohort study between 2008 and 2021. POPULATION: Women who conceived in the predefined period after the diagnosis of Budd–Chiari syndrome and/or portal vein thrombosis. METHODS AND MAIN OUTCOME MEASURES: We collected data on diagnosis and clinical features. The primary outcomes were maternal mortality and live birth rate. Secondary outcomes included maternal, neonatal and obstetric complications. RESULTS: Forty‐five women (12 Budd–Chiari syndrome, 33 portal vein thrombosis; 76 pregnancies) were included. Underlying prothrombotic disorders were present in 23 of the 45 women (51%). Thirty‐eight women (84%) received low‐molecular‐weight heparin during pregnancy. Of 45 first pregnancies, 11 (24%) ended in pregnancy loss and 34 (76%) resulted in live birth of which 27 were at term (79% of live births and 60% of pregnancies). No maternal deaths were observed; one woman developed pulmonary embolism during pregnancy and two women (4%) had variceal bleeding requiring intervention. CONCLUSIONS: The high number of term live births (79%) and lower than expected risk of pregnancy‐related maternal and neonatal morbidity in our cohort suggest that Budd–Chiari syndrome and/or portal vein thrombosis should not be considered as an absolute contraindication for pregnancy. Individualised, nuanced counselling and a multidisciplinary pregnancy surveillance approach are essential in this patient population. TWEETABLE ABSTRACT: Budd–Chiari syndrome and/or portal vein thrombosis should not be considered as an absolute contraindication for pregnancy.
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spelling pubmed-92934582022-07-20 Pregnancy outcomes in women with Budd–Chiari syndrome or portal vein thrombosis – a multicentre retrospective cohort study Wiegers, HMG Hamulyák, EN Damhuis, SE van Duuren, JR Darwish Murad, S Scheres, LJJ Gordijn, SJ Leentjens, J Duvekot, JJ Lauw, MN Hutten, BA Middeldorp, S Ganzevoort, W BJOG Research Articles OBJECTIVE: To evaluate current practice and outcomes of pregnancy in women previously diagnosed with Budd–Chiari syndrome and/or portal vein thrombosis, with and without concomitant portal hypertension. DESIGN AND SETTING: Multicentre retrospective cohort study between 2008 and 2021. POPULATION: Women who conceived in the predefined period after the diagnosis of Budd–Chiari syndrome and/or portal vein thrombosis. METHODS AND MAIN OUTCOME MEASURES: We collected data on diagnosis and clinical features. The primary outcomes were maternal mortality and live birth rate. Secondary outcomes included maternal, neonatal and obstetric complications. RESULTS: Forty‐five women (12 Budd–Chiari syndrome, 33 portal vein thrombosis; 76 pregnancies) were included. Underlying prothrombotic disorders were present in 23 of the 45 women (51%). Thirty‐eight women (84%) received low‐molecular‐weight heparin during pregnancy. Of 45 first pregnancies, 11 (24%) ended in pregnancy loss and 34 (76%) resulted in live birth of which 27 were at term (79% of live births and 60% of pregnancies). No maternal deaths were observed; one woman developed pulmonary embolism during pregnancy and two women (4%) had variceal bleeding requiring intervention. CONCLUSIONS: The high number of term live births (79%) and lower than expected risk of pregnancy‐related maternal and neonatal morbidity in our cohort suggest that Budd–Chiari syndrome and/or portal vein thrombosis should not be considered as an absolute contraindication for pregnancy. Individualised, nuanced counselling and a multidisciplinary pregnancy surveillance approach are essential in this patient population. TWEETABLE ABSTRACT: Budd–Chiari syndrome and/or portal vein thrombosis should not be considered as an absolute contraindication for pregnancy. John Wiley and Sons Inc. 2021-10-04 2022-03 /pmc/articles/PMC9293458/ /pubmed/34520620 http://dx.doi.org/10.1111/1471-0528.16915 Text en © 2021 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Research Articles
Wiegers, HMG
Hamulyák, EN
Damhuis, SE
van Duuren, JR
Darwish Murad, S
Scheres, LJJ
Gordijn, SJ
Leentjens, J
Duvekot, JJ
Lauw, MN
Hutten, BA
Middeldorp, S
Ganzevoort, W
Pregnancy outcomes in women with Budd–Chiari syndrome or portal vein thrombosis – a multicentre retrospective cohort study
title Pregnancy outcomes in women with Budd–Chiari syndrome or portal vein thrombosis – a multicentre retrospective cohort study
title_full Pregnancy outcomes in women with Budd–Chiari syndrome or portal vein thrombosis – a multicentre retrospective cohort study
title_fullStr Pregnancy outcomes in women with Budd–Chiari syndrome or portal vein thrombosis – a multicentre retrospective cohort study
title_full_unstemmed Pregnancy outcomes in women with Budd–Chiari syndrome or portal vein thrombosis – a multicentre retrospective cohort study
title_short Pregnancy outcomes in women with Budd–Chiari syndrome or portal vein thrombosis – a multicentre retrospective cohort study
title_sort pregnancy outcomes in women with budd–chiari syndrome or portal vein thrombosis – a multicentre retrospective cohort study
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9293458/
https://www.ncbi.nlm.nih.gov/pubmed/34520620
http://dx.doi.org/10.1111/1471-0528.16915
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