Budd- Chiari syndrome and pregnancy
-
摘要:
布加综合征是一种少见的肝脏疾病,其与妊娠之间相互影响。系统论述了布加综合征与妊娠的关系,并指出了在疾病诊断和治疗中的注意事项。其一,妊娠是布加综合征的危险因素。对于妊娠期间出现门静脉高压和(或)下腔静脉高压表现的患者,应高度怀疑合并布加综合征。其二,布加综合征患者妊娠具有一定的风险。经治疗病情稳定的患者可以妊娠,但孕期和产后须严密监查,以防止血栓复发。其三,布加综合征可导致女性不孕。原因不明的不孕患者应行腹部超声及CT检查,以排除布加综合征的可能。
Abstract:Budd- Chiari syndrome (BCS) is a rare liver disease, and there are mutual influences between BCS and pregnancy.The relationship between BCS and pregnancy is systematically discussed, and the points we should pay attention to in the diagnosis and treatment of this disease are pointed out as follows:First, pregnancy is a risk factor for BCS;pregnant women with the clinical manifestations of portal hypertension and (or) inferior vena cava hypertension should be highly suspected of having BCS.Second, pregnancy is risky in BCS patients;pregnancy is allowable in BCS patients who have a stable condition after treatment, but they should be kept under rigorous surveillance during pregnancy and after delivery to avoid thrombosis recurrence.Third, BCS may lead to infertility in women;patients with unexplained infertility should be evaluated by abdominal ultrasound and computed tomography to clarify the diagnosis of BCS.
-
Key words:
- Budd-Chiari syndrome /
- pregnancy /
- review
-
[1]VALLA DC.Primary Budd-Chiari syndrome[J].J Hepatol, 2009, 50 (1) :195-203. [2]TAO YQ, WANG P.Study on the significance of application of color Doppler ultrasound in evaluation of effect of intervention treatment in patients with Budd-Chiari sydrome[J].J Clin Exp Med, 2013, 12 (6) :413-415. (in Chinese) 陶艳清, 王萍.彩色多普勒超声在布加综合征介入治疗疗效评价中的应用价值[J].临床和实验医学杂志, 2013, 12 (6) :413-415. [3]VALLA DC.The diagnosis and management of the Budd-Chiari syndrome:Consensus and controversies[J].Hepatology, 2003, 38 (4) :793-803. [4]QI XS, WU FF, REN WR, et al.Thrombotic risk factors in Chinese Budd-Chiari syndrome patients.An observational study with a systematic review of the literature[J].Thromb Haemost, 2013, 109 (5) :878-884. [5]WANG ZG, LI CM, LI Z, et al.Evolution and prospects of Budd-Chiari syndrome[J].J Clin Hepatol, 2011, 27 (2) :113-115. (in Chinese) 汪忠镐, 李春民, 李震, 等.布-加综合征的进展与展望[J].临床肝胆病杂志, 2011, 27 (2) :113-115. [6]KESTEVEN P, HANLEY J, LOUGHNEY A.Pregnancy-associated venous thrombosis[J].Phlebology, 2012, 27 (Suppl 2) :s73-s80. [7]PERARNAU JM, BACQ Y.Hepatic vascular involvement related to pregnancy, oral contraceptives, and estrogen replacement therapy[J].Semin Liver Dis, 2008, 28 (3) :315-327. [8]DARWISH MURAD S, PLESSIER A, HERNANDEZ-GUERRA M, et al.Etiology, management, and outcome of the Budd-Chiari syndrome[J].Ann Intern Med, 2009, 151 (3) :167-175. [9]DAS HS, MOHAPATRA M, PANDA CR, et al.Profile of acute and chronic budd-chiari syndrome in coastal orissa, a 6-year prospective study[J].Hepatol Int, 2011, 5 (1) :363. [10]DELTENRE P, DENNINGER MH, HILLAIRE S, et al.Factor V Leiden related Budd-Chiari syndrome[J].Gut, 2001, 48 (2) :264-268. [11]DENNINGER MH, CHAIT Y, CASADEVALL N, et al.Cause of portal or hepatic venous thrombosis in adults:The role of multiple concurrent factors[J].Hepatology, 2000, 31 (3) :587-591. [12]DILAWARI JB, BAMBERY P, CHAWLA Y, et al.Hepatic outflow obstruction (Budd-Chiari syndrome) .Experience with 177patients and a review of the literature[J].Medicine, 1994, 73 (1) :21-36. [13]HOEKSTRA J, LEEBEEK FW, PLESSIER A, et al.Paroxysmal nocturnal hemoglobinuria in Budd-Chiari syndrome:findings from a cohort study[J].J Hepatol, 2009, 51 (4) :696-706. [14]KHUROO MS, DATTA DV.Budd-Chiari syndrome following pregnancy.Report of 16 cases, with roentgenologic, hemodynamic and histologic studies of the hepatic outflow tract[J].Am J Med, 1980, 68 (1) :113-121. [15]MALEKZADEH R, BIDAD K, RADMEHR A, et al.BuddChiari syndrome in Iran:An experience with 22 patients[J].Iranian J Med Sciences, 1994, 19 (3-4) :88-94. [16]MOHANTY D, SHETTY S, GHOSH K, et al.Hereditary thrombophilia as a cause of Budd-Chiari syndrome:A study from Western India[J].Hepatology, 2001, 34 (41) :666-670. [17]OKUDA H, YAMAGATA H, OBATA H, et al.Epidemiological and clinical features of Budd-Chiari syndrome in Japan[J].J Hepatol, 1995, 22 (1) :1-9. [18]RAUTOU PE, PLESSIER A, BERNUAU J, et al.Pregnancy:A risk factor for Budd-Chiari syndrome?[J].Gut, 2009, 58 (4) :606-608. [19]SAKR M, BARAKAT E, ABDELHAKAM S, et al.Epidemiological aspects of budd-chiari in Egyptian patients:A single-center study[J].World J Gastroenterol, 2011, 17 (42) :4704-4710. [20]SINGH V, SINHA SK, NAIN CK, et al.Budd-Chiari syndrome:Our experience of 71 patients[J].J Gastroenterol Hepatol, 2000, 15 (5) :550-554. [21]USKUDAR O, AKDOGAN M, SASMAZ N, et al.Etiology and portal vein thrombosis in Budd-Chiari syndrome[J].World J Gastroenterol, 2008, 14 (18) :2858-2862. [22]PLESSIER A, SIBERT A, CONSIGNY Y, et al.Aiming at minimal invasiveness as a therapeutic strategy for Budd-Chiari syndrome[J].Hepatology, 2006, 44 (5) :1308-1316. [23]JAMES A.Prevention and management of venous thromboembolism in pregnancy[J].Am J Med, 2007, 120 (10 Suppl 2) :s26-s34. [24]SUN ZH.Budd-Chiari syndrome and pregnancy[J].Guide China Med, 2011, 9 (24) :217-218. (in Chinese) 孙志华.布-加综合征与妊娠[J].中国医药指南, 2011, 9 (24) :217-218. [25]OUWENDIJK RJ, KOSTER JC, WILSON JH, et al.Budd-Chiari syndrome in a young patient with anticardiolipin antibodies:need for prolonged anticoagulant treatment[J].Gut, 1994, 35 (7) :1004-1006. [26]MARTINELLI P, MARUOTTI GM, COPPOLA A, et al.Pregnancy in a woman with a history of Budd-Chiari syndrome treated by portosystemic shunt, protein C deficiency and bicornuate uterus[J].Throm Haemost, 2006, 95 (6) :1033-1034. [27]VONS C, SMADJA C, FRANCO D, et al.Successful pregnancy after Budd-Chiari syndrome[J].Lancet, 1984, 324 (8409) :975. [28]SUN ZH, GAI MY.Clinical analysis of pregnancy with BuddChiari syndrome after intervention treatment[J].Chin J Clin Obstet Gynecol, 2000, 1 (2) :72-73. (in Chinese) 孙志华, 盖铭英.布-加氏综合征介入治疗后妊娠17例分析[J].中国妇产科临床杂志, 2000, 1 (2) :72-73. [29]RAUTOU PE, ANGERMAYR B, GARCIA-PAGAN JC, et al.Pregnancy in women with known and treated Budd-Chiari syndrome:Maternal and fetal outcomes[J].J Hepatol, 2009, 51 (1) :47-54. [30]SUN ZH.Interventional treatment for patient of Budd-Chiari syndrome with infertility[J].J TCM Univ of Hunan, 2011, 31 (4) :50-51. (in Chinese) 孙志华.Budd-Chiari综合征合并不孕介入治疗的临床分析[J].湖南中医药大学学报, 2011, 31 (4) :50-51. [31]DUAN HY, WU X, WANG ZG, et al.Mesojugular shunt for Budd-Chiari syndrome:A case report with long-term follow-up[J].Ann Vasc Surg, 2010, 24 (7) :953, e1-e5. [32]EBRAHIMI M.Treatment of the budd-chiari syndrome (BCS) caused by membranous obstruction of inferior vena cava with percutaneous transluminal angioplasty:Report of an amazing relation between undiagnosed BCS and infertility[J].J Invasive Cardiol, 2009, 21 (9) :e166-e167. [33]MAHAPATRA A, SHUKLA A, GROVER AS, et al.Hepatic venous outflow tract obstruction is associated with poor outcome of pregnancy[J].Gastroenterology, 2011, 140 (5) :s953. [34]SHRESTHA SM, OKUDA K, UCHIDA T, et al.Endemicity and clinical picture of liver disease due to obstruction of the hepatic portion of the inferior vena cava in Nepal[J].J Gastroenterol Hepatol, 1996, 11 (2) :170-179. [35]SUN ZH, ZHAO JX.Interventional treatment for 27 patientS of Budd-Chiari syndrome with infertility[J].Shandong Med J, 2002, 42 (8) :28. (in Chinese) 孙志华, 赵金旭.介入治疗布-加氏综合征合并不孕症27例临床观察[J].山东医药, 2002, 42 (8) :28. [36]YIN CY, YUAN J, SUN BZ.Budd-Chiari syndrome and infertility[J].Reproduct Contracept, 1997, 17 (2) :119-120. (in Chinese) 尹超英, 元健.Budd-Chiari综合征与不孕症[J].生殖与避孕, 1997, 17 (2) :119-120.
计量
- 文章访问数: 3148
- HTML全文浏览量: 14
- PDF下载量: 637
- 被引次数: 0