Pregnancy and portal hypertension

The course of pregnancy in three patients with portal hypertension is described. The cause of portal hypertension was cirrhosis in one and portal vein obstruction in two (one of these had previous shunt surgery). The patient with cirrhosis had an episode of encephalopathy at week 27, the rest of the patients had an uneventful pregnancy. All three had preterm vaginal deliveries at week 33, 31 and 37 of pregnancy. The clinical features of pregnancy in women with portal hypertension was reviewed in the literature. There is agreement that the risk of preterm delivery increases and pregnancy does not influence maternal prognosis. Vaginal delivery can be anticipated in most women and cesarean section is reserved for obstetric indications. Pregnancy in these women should be managed in tertiary care centers with close collaboration between perinatologists, internists and surgeons.