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<p>Pregnancy in patients with non-cirrhotic portal hypertension (NCPH) poses significant clinical challenges. Portal hypertension–related complications occur in 30 to 50% of pregnancies. Furthermore, pregnancy with non-cirrhotic portal hypertension is associated with an increased risk of bad perinatal outcomes (29% chance of abortion and 11–18% higher perinatal death). There is a lack of evidence and established guidelines for managing pregnancy in non-cirrhotic portal hypertension (NCPH). This review intends to address the gap by summarizing what is known on the subject. Herein, we present the case of a 26-year-old female with NCPH, who presented with amenorrhea for 2&#xa0;months. During pregnancy, she underwent three sessions of endoscopic variceal ligation (EVL) and one sitting of glue injection and was started on carvedilol for secondary prophylaxis. She developed intrauterine growth restriction (IUGR), necessitating an emergency caesarean section at 31&#xa0;weeks. The baby, weighing 1.031&#xa0;kg, required neonatal intensive care, but both mother and child were eventually discharged in stable condition. This case underscores the critical importance of a multidisciplinary approach involving obstetrics, hepatology, gastroenterology, and neonatology to optimize outcomes in high-risk pregnancies complicated by NCPH. It also adds to the limited existing literature on pregnancy management in NCPH, highlighting the feasibility and safety of endoscopic and pharmacologic interventions during gestation. Optimizing the patient’s condition before conception and ensuring vigilant prenatal care can significantly reduce complications.</p>

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Pregnancy in Non-Cirrhotic Portal Hypertension: A Case Report and Comprehensive Literature Review

  • 期刊论文

  • 发表日期：

    2025年6月20日

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  • Sangam Jha,
  • Sharda Jha,
  • Vikas Chandra Jha,
  • Raveena Bhagat

摘要

Pregnancy in patients with non-cirrhotic portal hypertension (NCPH) poses significant clinical challenges. Portal hypertension–related complications occur in 30 to 50% of pregnancies. Furthermore, pregnancy with non-cirrhotic portal hypertension is associated with an increased risk of bad perinatal outcomes (29% chance of abortion and 11–18% higher perinatal death). There is a lack of evidence and established guidelines for managing pregnancy in non-cirrhotic portal hypertension (NCPH). This review intends to address the gap by summarizing what is known on the subject. Herein, we present the case of a 26-year-old female with NCPH, who presented with amenorrhea for 2 months. During pregnancy, she underwent three sessions of endoscopic variceal ligation (EVL) and one sitting of glue injection and was started on carvedilol for secondary prophylaxis. She developed intrauterine growth restriction (IUGR), necessitating an emergency caesarean section at 31 weeks. The baby, weighing 1.031 kg, required neonatal intensive care, but both mother and child were eventually discharged in stable condition. This case underscores the critical importance of a multidisciplinary approach involving obstetrics, hepatology, gastroenterology, and neonatology to optimize outcomes in high-risk pregnancies complicated by NCPH. It also adds to the limited existing literature on pregnancy management in NCPH, highlighting the feasibility and safety of endoscopic and pharmacologic interventions during gestation. Optimizing the patient’s condition before conception and ensuring vigilant prenatal care can significantly reduce complications.