Portal hypertension in pregnancy.

IF 2.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Current Opinion in Gastroenterology Pub Date : 2025-05-01 Epub Date: 2025-02-19 DOI:10.1097/MOG.0000000000001091
Dorien Pint, Yooyun Chung, Michael A Heneghan
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引用次数: 0

Abstract

Purpose of review: This review highlights the management, maternal and fetal outcomes, and the critical role of prepregnancy counseling for women with portal hypertension (PHT), a topic of growing clinical relevance as pregnancies in women with PHT have increased over the last two decades.

Recent findings: Pregnancy exacerbates PHT due to physiological changes that increase blood flow and vascular resistance, raising the risk of life-threatening complications like variceal bleeding. The distinction between noncirrhotic (NCPH) and cirrhotic portal hypertension (CPH) is essential, as maternal risks vary significantly.

Summary: Optimal care for women with PHT requires preconception counseling to assess risks, adjust medications, and plan necessary investigations such as variceal and splenic artery aneurysm screening and, if necessary, plan additional interventions. A multidisciplinary team - including hepatologists, obstetricians, anesthetists, and radiologists - is crucial for personalized management, addressing both the mode of delivery and peripartum care. While PHT complicates pregnancy, favorable outcomes are achievable with proactive planning and close follow-up during pregnancy.

妊娠期门静脉高压。
综述目的:本综述强调了门静脉高压(PHT)妇女的管理、母胎结局以及孕前咨询的关键作用,在过去的二十年中,随着PHT妇女怀孕的增加,这一主题越来越具有临床意义。最近的研究发现:由于血液流动和血管阻力增加的生理变化,怀孕加剧了PHT,增加了危及生命的并发症的风险,如静脉曲张出血。区分非肝硬化(NCPH)和肝硬化门脉高压(CPH)是必要的,因为产妇的风险差异很大。总结:对PHT女性的最佳护理需要孕前咨询,以评估风险,调整药物,计划必要的调查,如静脉曲张和脾动脉瘤筛查,必要时,计划额外的干预措施。一个多学科的团队——包括肝病专家、产科医生、麻醉师和放射科医生——对个性化管理至关重要,解决了分娩方式和围产期护理问题。虽然PHT使妊娠复杂化,但在妊娠期间通过积极的计划和密切的随访是可以获得良好的结果的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Current Opinion in Gastroenterology
Current Opinion in Gastroenterology 医学-胃肠肝病学
CiteScore
5.30
自引率
0.00%
发文量
137
审稿时长
6-12 weeks
期刊介绍: ​​​​​​​Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in Gastroenterology features hand-picked review articles from our team of expert editors. With twelve disciplines published across the year – including gastrointestinal infections, nutrition and inflammatory bowel disease – every issue also contains annotated references detailing the merits of the most important papers.
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