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Pregnancy outcomes in patients with Budd–Chiari syndrome: A tertiary care experience

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Abstract

Background

Budd–Chiari syndrome (BCS) is associated with infertility and adverse pregnancy outcomes in affected females. Scant literature is available on the effect of an endovascular intervention on fertility and the outcome of future pregnancies in these patients.

Aims

To assess the infertility rates, maternal and fetal outcomes of pregnancy and effect of endovascular intervention in women with BCS.

Methods

In this retrospective analysis, 121 female patients with BCS attending our liver clinic from 2017 to 2020 were included. Demographic details, intervention details, pregnancies — pre- and post-intervention — and fetal outcomes were noted.

Results

BCS was diagnosed pre-conception in 58 women (group 1; median age: 22 years), during/after pregnancy, but before completion of family in 39 (group 2; median age: 27 years), and after completion of family in 24 (group 3; median age: 34 years). Median Child–Turcotte–Pugh (CTP) and model for end-stage liver disease (MELD) scores were 7 and 12, respectively. The primary infertility rate was 19.8% (24/121). In group 1, 15 women with primary infertility underwent endovascular intervention with 5/15 (33%) women conceiving subsequently, resulting in four live births and seven abortions. In group 2, five women developed BCS during pregnancy and 11 postpartum; 11/39 had a history of one or more abortions. Overall, 8/34 (23.5%) who underwent endovascular intervention had 4/8 (50%) successful pregnancies. In group 3, no patient had any major complications during past pregnancies. The mode of delivery was vaginal in 88% of cases. No congenital anomaly/major bleeding episodes/decompensation/maternal mortality occurred.

Conclusions

Infertility is common in patients with BCS. Pregnancy is well-tolerated in those with compensated liver disease.

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Author information

Authors and Affiliations

  1. Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, 110 029, India

    Sagnik Biswas, Sabreena Sheikh, Manas Vaishnav, Anshuman Elhence, Abhinav Anand &  Shalimar

  2. Mayo Clinic, Rochester, MN, USA

    Naba Farooqui

  3. Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, 110 029, India

    Shivanand Gamanagatti

Authors
  1. Sagnik Biswas
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  2. Sabreena Sheikh
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  3. Manas Vaishnav
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  4. Anshuman Elhence
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  7. Shivanand Gamanagatti
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  8. Shalimar
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Contributions

Sagnik Biswas, - acquisition of data; analysis and interpretation of data; drafting of the manuscript. Sabreena Sheikh, - acquisition of data; drafting of the manuscript. Manas Vaishnav, - acquisition of data, analysis, and interpretation of data, drafting of the manuscript. Anshuman Elhence, - acquisition of data, analysis, and interpretation of data, drafting of the manuscript. Naba Farooqui, - interpretation of data and critical inputs. Abhinav Anand, - acquisition of data, analysis, and interpretation of data, drafting of the manuscript. Shivanand Gamanagatti, - acquisition of data, analysis, and interpretation of data, drafting of the manuscript. Shalimar, - concept; acquisition of data; analysis and interpretation of data; critical revision.

Corresponding author

Correspondence to Shalimar.

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Conflict of interest

SB, SS, MV, AE, NF, AA, SG, and S declare that they have no conflict of interest.

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The study was performed conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

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Biswas, S., Sheikh, S., Vaishnav, M. et al. Pregnancy outcomes in patients with Budd–Chiari syndrome: A tertiary care experience. Indian J Gastroenterol 42, 96–105 (2023). https://doi.org/10.1007/s12664-022-01307-7

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