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Hypertension portale compliquée d’hémorragie par rupture de varices œsophagiennes chez la femme enceinte

  • Pratiques Professionnelles Quel Type de Structure pour Quelle Endoscopie?
  • Cas Cliniques
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Acta Endoscopica

Résumé

La prise en charge thérapeutique de l’hypertension portale en cours de grossesse compliquée d’hémorragie digestive par rupture de varices œsophagiennes fait appel actuellement aux moyens endoscopiques: la sclérose et la ligature qui sont efficaces, tolérables et sans danger ni pour la mère ni pour la fœtus. Nous rapportons trois cas traités avec succès par sclérothérapie: deux patientes ont été sclérosées en urgence après saignement digestif pendant leur grossesse, pour la 3ème patiente, la sclérothérapie a été démarrée avant la grossesse et les séances ont été poursuivies durant la grossesse sans aucun danger ni pour la mère ni pour le fœtus.

Summary

During pregnancy, management of portal hypertension complicated by digestive haemorrhage due to esophageal varices rupture consists of endoscopic injection sclerotherapy (EIS) or endoscopic band ligation (EVL). These treatments are well tolerated and with no danger for the mother or the child. We report three cases of pregnant women with oesophageal varices treated by EIS (two received emergency EIS) and were safely delivered. The third patient began the EIS before becoming pregnant and continued during her pregnancy. The EIS was effective, well tolerated and safe for both mother and child.

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Références

  1. Andey EK, Cohen A. Liver disease associated with pregnancy. Ann Clin Lab Sci 1990; 20: 233–8.

    Google Scholar 

  2. Moore RM, Huges PK. Cirrhosis of the liver in pregnancy. A review of the littérature and report of three cases. Obstest Gynocol 1960; 15: 453–8.

    Google Scholar 

  3. Niven P, Williams D, Zeegn R. Pregnancy following the surgical treatment of portal hypertension Ann J Obs Gyn 1971; 110: 1100–12.

    CAS  Google Scholar 

  4. Choudhury KL, Chogtu L. Chronic active hepatitis and pregnancy. J Indian Med Assoc 1974; 68: 196–8.

    Google Scholar 

  5. Crepin G. Cirrhose hépatique et grossesse. A propos de cinq observations. Med Chir Dig 1977; 6: 127–35.

    PubMed  CAS  Google Scholar 

  6. Restaino A, Campobasso C. Cirrhosis and pregnancy. A case report and review of literature. Clin Exp Obst Gyn 1996; 23: 240–7.

    CAS  Google Scholar 

  7. Varma RR, Michelsohn NH. Pregnancy in cirrhotic and non cirrhotic portal hypertension. Obst Gyn 1977; 50: 217–22.

    CAS  Google Scholar 

  8. Bismuth H, Franco D. L’hypertension portale, techniques chirurgicales, appareil digestif, Encycl Med Chir (Paris) 4406–408.

  9. Bretagne JF, Bergerault P, Grall JY. Grossesse au cours des hypertensions portales par bloc pré-hépatique. A propos des risques encourus pas la mère et le foetus. Ann Gastroentérol Hépatol 1981; 17: 33–5.

    Google Scholar 

  10. Paternoster DM, Fldreani AR, Paggioro A. Portal hypertension in a pregnant woman. Minerva Gynecol 1996; 48: 243–5.

    CAS  Google Scholar 

  11. Potzi R, Ferenci P, Gangl A. Endoscopic sclerotherapy of oesophageal varices during pregnancy. Case report. Z Gastroenterol 1991; 29: 246–7.

    CAS  Google Scholar 

  12. Soto-Albors C, Rayburn WF. Portal hypertension and hypersplenism in pregnancy secondary to chronic Shistosomiasis. A case report. J Reproductive Med 1984; 29: 345–8.

    CAS  Google Scholar 

  13. Palmer ED. Effect of Valsalva’s maneuvre on portal pressure. Am J Med Sci 1961; 6: 242–3.

    Google Scholar 

  14. Donaldson LB, Plant RK. Pregnancy complicated by extrahepatic portal hypertension: review of literature and report of two cases. Amer J Obstest Gyn 1971; 15: 255–64.

    Google Scholar 

  15. Heriot JA, Steven CM, Satti RS. Grossesse à terme chez une femme ayant subi une anastomose porto cave et césarienne itérative. Gyn Obst (Paris) 1964; 63: 477–488.

    Google Scholar 

  16. Britton RC. Pregnancy and esophageal varices. Am J Surg 1982; 143: 421–5.

    Article  PubMed  CAS  Google Scholar 

  17. Cheng YS. Pregnancy in liver cirrhosis and or hypertension. Am J Obstet Gynecol 1977; 128: 812–20.

    PubMed  CAS  Google Scholar 

  18. Russell MA, Craigo SD. Cirrhosis and portal hypertension in pregnancy. Sem Perinatology 1998; 22: 156–65.

    Article  CAS  Google Scholar 

  19. Pajor A, Lehoczky D. Pregnancy and extrahepatic portal hypertension, review and report on the management. Gyn Obst Invest 1990; 30: 193–7.

    CAS  Google Scholar 

  20. Mahfoudi I, Mabrouk H. Association de l’hypertension portale d’origine extra hépatique et grossesse. A propos de trois observations. Maghreb médical 1994; 285: 28–33.

    Google Scholar 

  21. Pauzner D, Wolman I. Endoscopic sclerotherapy in extrahepatic portal hypertension in pregnancy. Am J Obstet Gyn 1991; 164: 152–3.

    CAS  Google Scholar 

  22. Timothy T, Mc Michen S. Successful pregnancy outcome in patient with congenital biliary atresia. Obst Gyn 1992; 8: 492–4.

    Google Scholar 

  23. Iwase H, Morise K, Kawase T. Endoscopic injection sclerotherapy for esophageal varices during pregnancy. J Clin Gastroenterol 1994; 18: 80–3.

    Article  PubMed  CAS  Google Scholar 

  24. Querlieu D, Crepin G, Paris JC. L’axe hypothalamo-ovarien chez la femme cirrhotique éthylique. Etude hormonale plasmatique de 54 observations. J Gyn Obst Biol Repr 1981; 10: 389.

    Google Scholar 

  25. Harnett J, Miller AD, Hurley RJ, Bhavani-Shankar K. Pregnancy labour and delivery in a Jehovah’s witness with esophageal varices and thrombocytopenia. Can I Anesth 2000; 47: 1253–5.

    Article  CAS  Google Scholar 

  26. Starkel P. Endoscopic band ligation: a safe technique to control bleeding esophageal varices in pregnancy. Gastro Intest Endosc 1998; 48: 212–4.

    Article  CAS  Google Scholar 

  27. Zeeman GG, Moise KJ. Prophylactic banding of severe esophageal varices associated with liver cirrhosis in pregnancy. Obstet Gynecol 1999; 95: 842.

    Article  Google Scholar 

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Authors and Affiliations

  1. Clinique Médicale «C», CHU Ibn-Sina, Rabat, Maroc

    Latifa Elkihal, S. El Jastimi, R. Afifi & A. Essaïd

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  1. Latifa Elkihal
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  2. S. El Jastimi
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  3. R. Afifi
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  4. A. Essaïd
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Elkihal, L., El Jastimi, S., Afifi, R. et al. Hypertension portale compliquée d’hémorragie par rupture de varices œsophagiennes chez la femme enceinte. Acta Endosc 35 (Suppl 1), 503–507 (2005). https://doi.org/10.1007/BF03003906

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  • DOI: https://doi.org/10.1007/BF03003906

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