Pregnancy Outcome in Patients with Budd Chiari Syndrome: A Single Centre Experience

Abstract

Background: Budd-Chiari syndrome (BCS) is a rare disorder caused by hepatic venous outflow obstruction and resulting hepatic dysfunction due to sinusoidal congestion, ischaemic injury to the liver and portal hypertension. The main mechanism for BCS is thrombosis of the hepatic veins or of the terminal portion of the inferior vena cava Objectives: The aim beyond this study is to assess the maternal and foetal outcome in a group of women who became pregnant while having BCS. Patients and Methods: The present study was conducted on 32 patients with Budd- Chiari syndrome admitted to Ain Shams University Hospitals, Tropical Medicine department or attended the outpatient clinics during the period from May 2006 to March 2019 who became pregnant after diagnosis by BCS (retrospective and prospective study). 7 patients of them had multiple abortions so we have 32 female patients with 46 pregnancy. Results: The mean age of our patients is 31.4 years with age of menarche ranging from 13 to 15 years within the normal range. And the mean duration between diagnosis and pregnancy is 4.5 years. As regards contraception more than half of our patients did not receive any method of contraception and most of the patients (71%) had abortion before diagnosis. Conclusion: BCS cannot be considered a contraindication to pregnancy in stable patients with a well-controlled disease. Fetal outcome remains relatively poor, which is at least partly related to underlying prothrombotic disorders so patients should be accurately informed of fetal and maternal risk, of such pregnancies.