Khan Faisal, Rowe Ian, Martin Bill, Knox Ellen, Johnston Tracey, Elliot Charlie, Lester Will, Chen Frederick, Olliff Simon, Mehrzad Homoyon, Zia Zergham, Tripathi Dhiraj
Faisal Khan, Ian Rowe, Dhiraj Tripathi, Liver Unit, Queen Elizabeth Hospital, Birmingham B15 2GW, United Kingdom.
World J Hepatol. 2017 Jul 28;9(21):945-952. doi: 10.4254/wjh.v9.i21.945.
To analyse the risk of pregnancy (a prothrombotic state) in patients with Budd-Chiari Syndrome (BCS).
Retrospective study of pregnancy in women with known BCS at single center from January 2001 to December 2015.
Out of 53 females with BCS, 7 women had 16 pregnancies. Median age at diagnosis of BCS in these women was 25 years (range 21-34 years). At least one causal factor for BCS was identified in 6 women (86%). Six women had undergone radiological decompressive treatment. All patients had anticoagulation. Six fetuses were lost before 20 wk gestation in 2 women. There were 9 deliveries over 32 wk gestation and one delivery at 27 wk. All infants did well. Seven babies were born by emergency caesarean section. There were no cases of thrombosis. Two patients had notable vaginal (PV) bleeding in 3 pregnancies. None of the patients had variceal haemorrhage. Two patients were diagnosed with pulmonary hypertension, one during pregnancy and the other in the post-partum period. There was no maternal mortality.
Maternal outcomes in patients with treated BCS are favourable and fetal outcomes beyond 20 wk gestation are good. There has been increased rate of caesarean section. Pulmonary hypertension is an important finding that needs further validation. These patients should be managed in centers experienced in treating high-risk pregnancies.
分析布加综合征（BCS）患者的妊娠风险（一种血栓前状态）。
对2001年1月至2015年12月在单中心确诊为BCS的女性患者的妊娠情况进行回顾性研究。
在53例BCS女性患者中，7例女性有16次妊娠。这些女性确诊BCS时的中位年龄为25岁（范围21 - 34岁）。6例女性（86%）至少确定了一个BCS的病因。6例女性接受了放射减压治疗。所有患者均接受抗凝治疗。2例女性中有6例胎儿在妊娠20周前丢失。有9例分娩发生在妊娠32周后，1例在27周分娩。所有婴儿情况良好。7例婴儿通过急诊剖宫产出生。无血栓形成病例。2例患者在3次妊娠中有明显的阴道出血。无患者发生静脉曲张出血。2例患者被诊断为肺动脉高压，1例在孕期，另1例在产后。无孕产妇死亡。
接受治疗的BCS患者的母体结局良好，妊娠20周后的胎儿结局良好。剖宫产率有所增加。肺动脉高压是一个需要进一步验证的重要发现。这些患者应在有治疗高危妊娠经验的中心进行管理。
