Extrahepatic Portal- Vein Obstruction in Pregnancy

Abstract

Extrahepatic portal-vein obstruction (EHPVO) presents significant challenges in pregnancy due to the increased risk of variceal bleeding driven by hemodynamic changes. This prospective observational study at Sanjay Gandhi Hospital, Rewa, included 60 pregnant women diagnosed with EHPVO, monitored over a year to assess the efficacy of management strategies and pregnancy outcomes. Results showed that 20% of the women experienced variceal bleeding, predominantly in the third trimester. Prophylactic interventions such as endoscopic variceal ligation were implemented in 50% of the cases, and 40% of the participants received non-selective beta-blockers. The majority of pregnancies (95%) were carried to term without any maternal fatalities, and half of the deliveries were performed via cesarean section due to obstetric reasons. These findings indicate that with proactive and combined endoscopic and pharmacological management, EHPVO in pregnant women can be effectively controlled, leading to positive maternal and fetal outcomes. The study underscores the importance of vigilant monitoring and a multidisciplinary approach in the management of these high-risk pregnancies.

Keywords: EHPVO, Pregnancy, Variceal Bleeding, Endoscopic Management