Pregnancy and extrahepatic portal hypertension. Review and report on the management.

The authors report on 17 pregnancies of 7 patients with extrahepatic portal hypertension (EPH). Before conception all patients underwent splenectomy, in 5 of them portosystemic shunts were performed and 3 women received esophageal sclerotherapy as well. Three patients had esophageal varices before and throughout the pregnancy, and in 1 patient pregnancy was electively terminated on 4 occasions for previously bleeding varices; then the sclerotherapy eradicated the varices, and she had a successful pregnancy, in which the varices recurred. No gastrointestinal bleeding was seen during the pregnancies. There were toxemia in 1, edema in 2, anemia in 3, cesarean section in 10, puerperal endometritis in 4 and puerperal thrombophlebitis of the leg in 2 pregnancies. One spontaneous abortion and 12 live births among them with 3 preterm infants were encountered. All newborns were healthy and appropriate for their gestational age. The authors review the maternal as well as fetal complications and discuss the current management for pregnant women with EPH.