Medical disorders of pregnancy: Case report identification and management of abdominal wall varices in pregnancy

Amber M. Wood, Chad A. Grotegut, James Ronald, Waleska Pabon-Ramos, Christina Pedro, Stuart J. Knechtle, Ewa Wysokinska, Geoffrey D. Rubin, Carla W. Brady, Jennifer B. Gilner

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

BACKGROUND: Portal hypertension in pregnancy is associated with elevated risk of variceal hemorrhage. Ectopic varices, those located outside the esophagus or stomach, are rare but have a high risk of associated maternal morbidity or mortality. CASE: A 31-year-old woman, gravida 2 para 0010, with cirrhosis and portal hypertension was found to have abdominal wall ectopic varices on third-trimester obstetric ultrasonography. Computed tomography angiography confirmed these findings. Given concern for catastrophic hemorrhage during delivery, she underwent transjugular intrahepatic portosystemic shunt placement at 35 weeks of gestation, with reduction in the pressure gradient within the portosystemic circulation. She subsequently underwent an uncomplicated cesarean delivery. CONCLUSION: Identification of ectopic varices on obstetric ultrasonography may allow for treatment before delivery, decreasing the risk of serious maternal morbidity or mortality.

Original languageEnglish (US)
Pages (from-to)882-887
Number of pages6
JournalObstetrics and gynecology
Volume132
Issue number4
DOIs
StatePublished - 2018
Externally publishedYes

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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