High-risk third trimester pregnancy with decompensated cirrhosis safely delivered following emergent preoperative interventional radiology for mitigation of variceal bleeding.

Journal Article (Journal Article)

Coagulopathy coupled with severe portal hypertension in the setting of cirrhosis increases the risk of mortality from variceal bleeding in pregnant women. Studies suggest transjugular intrahepatic portosystemic shunt (TIPS) creation to be a safe procedure during pregnancy in preventing variceal bleeding complications; however, it is not typically employed in severely decompensated cirrhosis. This case report of a pregnant woman presenting at 34.7 weeks' gestation demonstrates successful variceal mapping, emergent TIPS creation and variceal embolization to allow safe cesarean delivery despite severe hypofibrinogenemia and decompensated alcoholic cirrhosis. With careful medical optimization, angiographic imaging and vascular interventional radiology may be employed outside of usual indications to achieve safe pregnancy delivery and postpartum recovery.

Full Text

Duke Authors

Cited Authors

  • Park, C; Patel, YA; Suhocki, P; Dorsey, C; Kapila, N; Tang, L; Gilner, J

Published Date

  • December 2020

Published In

Volume / Issue

  • 68 /

Start / End Page

  • 143 - 147

PubMed ID

  • 32615516

Electronic International Standard Serial Number (EISSN)

  • 1873-4499

Digital Object Identifier (DOI)

  • 10.1016/j.clinimag.2020.06.032

Language

  • eng

Conference Location

  • United States