Pregnancy in women with portal hypertension carries maternal and foetal risks. We report a case of a woman with porto-sinusoidal vascular disorder (PSVD) and partial portal vein thrombosis, who developed variceal bleeding during pregnancy. Haemorrhage was refractory to endoscopic treatment and required placement of a transjugular intrahepatic portosystemic shunt (TIPS), the pregnancy continued and resulted in the delivery of a healthy infant at 38 weeks. Long-term follow-up confirmed TIPS patency, and the patient subsequently had two further pregnancies. This case highlights the challenges of managing portal hypertension in pregnancy, the role of TIPS, and the importance of individualized thrombotic and haemorrhagic risk assessment.
Filipe Andrade (Sun,) studied this question.