Maternal and Fetal outcome in pregnancies complicated by portal hypertension. An observational study.

Pregnant women with a diagnosis of portal hypertension, based on a history of GI bleed, jaundice, and ascites, presence of varices on endoscopy, presence of collaterals in spleno-portal axis and dilated portal vein, i.e., more than 13 mm on Doppler ultrasound8, will be identified from the admission records of the labour ward, antenatal wards, HDU, and the Obstetric Intensive Care Unit. Details of those who had undergone a portosystemic shunt surgery with/without splenectomy for portal hypertension and its complications will be recorded. The cause of portal hypertension will be recorded as – Cirrhotic or Non-cirrhotic. The non-cirrhotic will be further categorized into NCPF and EHPVO.  If the cause of cirrhosis is known that also will be collected.

Demographic details including age during pregnancy, parity, age at the time of diagnosis, clinical details such as etiology of portal hypertension, duration and course of the disease and management including medication, endoscopic findings, details of endoscopic or open surgery, sclerotherapy and the treatment received during pregnancy will be recorded. Medical complications like hematemesis, any massive bleed, anemia, severe thrombocytopenia, need for blood products, or any decompensation of hepatic function (clinical and/ or biochemical), obstetric complications during pregnancy including abortions, antepartum hemorrhage, hypertensive disorder of pregnancy and fetal growth restriction; the timing and mode of delivery, any peripartum complications such as postpartum hemorrhage, and the neonatal outcomes like birth weight, neonatal intensive care unit (NICU) admissions and deaths will be collected and analysed. The details of any complications till discharge form the hospital will be recorded.