Pregnancy outcomes in women with Budd Chiari Syndrome before onset of symptoms and after treatment

作者：Akash Shukla, Abhishek Sadalage, Deepak Gupta, Amit Gupte, Anupam Mahapatra, Dipendu Mazumder, Chirag Shah, Tejas Modi, Megha Meshram, Prashant Dhore, Shobna Bhatia · 发表于：Liver International · 年份：2017 · DOI：10.1111/liv.13552 · 被引用次数：21 · 研究领域：Liver Disease and Transplantation、Cardiovascular Issues in Pregnancy、Myeloproliferative Neoplasms: Diagnosis and Treatment

BACKGROUND & AIMS: Pregnancy is known to have poor outcomes in women with Budd Chiari syndrome. There are no data on fertility and pregnancy outcomes prior to onset of symptoms or the effect of therapy on these parameters. We therefore evaluated reproductive profile of women with Budd Chiari Syndrome before the onset of symptoms and after therapy. PATIENTS AND METHODS: Eighty women with Budd Chiari Syndrome (29 years [20-45]) were enrolled over 8 years. Baseline demographic characteristics, disease severity, thrombophilic disorders and treatment were reviewed. Their obstetric history before symptoms and after therapy was noted and compared. RESULTS: Sixty women conceived at least once (150 pregnancies) before symptom onset and 20 had primary infertility. Eighty-one pregnancies resulted in live births and remaining 69 pregnancies had adverse pregnancy outcomes. Post-intervention, 28 women (15 with primary infertility) attempted conception. Thirteen patients conceived 15 times. More women had live births after successful therapy as compared to presymptomatic period (0/28 vs 5/28 P = .000, Odds ratio5.6; 95% CI: 2.16-14.5). In women with primary infertility, conception (0/15 vs 3/15 P = .007, Odds ratio 5, 95% CI: 1.44-17.27) and proportion of live births (0/15 vs 2/15 P = .002, Odds ratio 7.5, 95% CI: 1.71-32.79) was higher as compared to presymptomatic period. CONCLUSION: Primary infertility is common and pregnancy outcomes are poor before the onset of symptoms in women with B...