BACKGROUND AND PURPOSE: 

• Budd-Chiari syndrome (obstruction of the hepatic venous outflow caused by thrombosis of the hepatic veins or proximal IVC) and portal vein thrombosis are unusual manifestations of venous thromboembolism 
• Wiegers et al. (BJOG, 2021) evaluated current practice and outcomes of pregnancy in women with Budd-Chiari syndrome and/or portal vein thrombosis 

METHODS: 

• Multicenter retrospective cohort study  
• Population 
  • Women who conceived in the study period after a diagnosis of Budd-Chiari syndrome and/or portal vein thrombosis 
• Primary outcomes 
  • Maternal mortality 
  • Live birth rate 
• Secondary outcomes 
  • Maternal, neonatal, and obstetric complications 

RESULTS: 

• 45 women | 76 pregnancies 
  • Budd-Chiari syndrome: 12 women 
  • Portal vein thrombosis: 33 women 
• Presence of underlying prothrombotic disorders: 51% 
• Received low-molecular-weight heparin during pregnancy: 84% 
• Neonatal outcomes of 45 first pregnancies 
  • Pregnancy loss: 24% 
  • Live birth: 76% | 79% of live births were at term  
• Maternal outcomes  
  • There were no maternal deaths 
  • Pulmonary embolism during pregnancy: 1 woman 
  • Variceal bleeding requiring intervention: 4% (2 women) 

CONCLUSION: 

• Women with a previous diagnosis of Budd-Chiari syndrome experienced a high percentage of live births at term  
  • There were also fewer than expected major maternal or neonatal morbidities  
• However, a multidisciplinary approach with individualized care is still required to optimize outcomes  
• The authors conclude 

The high number of term live births and lower than expected rate of pregnancy-related maternal and foetal morbidity in our small cohort indicate that there is no absolute contra-indication for pregnancy in patients with Budd-Chiari syndrome and/or portal vein thrombosis 

Learn More – Primary Sources: 

Pregnancy outcomes in women with Budd-Chiari syndrome or portal vein thrombosis A multicentre retrospective cohort study 

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