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Transjugular Intrahepatic Portosystemic Shunt Placement During Pregnancy: A Case Series of Five Patients.

Abstract：

BACKGROUND AND AIMS:Complications of portal hypertension, such as variceal hemorrhage and ascites, are associated with significant increases in both mortality and complications during pregnancy. Transjugular intrahepatic portosystemic shunt (TIPS) is a well-established procedure for treating portal hypertension, but the safety of TIPS during pregnancy is largely unknown. In this series, we review five patients who underwent TIPS placement while pregnant and describe their clinical outcomes. METHODS:Five pregnant patients with cirrhosis and portal hypertension underwent elective TIPS for complications of portal hypertension (four for secondary prevention of variceal bleeding and one for refractory ascites). Outcomes measured were recurrent bleeding episodes or need for further paracenteses during pregnancy, estimated radiation dose to the fetus and gestational age at delivery. All patients were followed after delivery to evaluate technical and clinical success of the procedure. RESULTS:All five patients survived pregnancy and went on to deliver successfully. When TIPS was performed for secondary prevention of variceal bleeding (n = 4), no patients demonstrated variceal bleeding after TIPS placement. When TIPS was performed for refractory ascites (n = 1), no further paracenteses were required. All patients delivered successfully, albeit prematurely. Average radiation dose estimated to the fetus was 16.3 mGy. CONCLUSIONS:This series suggests that TIPS can be performed in selective pregnant patients with portal hypertension, with little added risk to the mother or fetus.

journal_name

Cardiovasc Intervent Radiol

journal_title

Cardiovascular and interventional radiology

authors

Ingraham CR,Padia SA,Johnson GE,Easterling TR,Liou IW,Kanal KM,Valji K

doi

10.1007/s00270-015-1053-z

subject

Has Abstract

pub_date

2015-10-01 00:00:00

pages

1205-10

issue

5

eissn

0174-1551

issn

1432-086X

pii

10.1007/s00270-015-1053-z

journal_volume

38

pub_type

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