HYPERTENSION PORTALE ET GROSSESSE : EXPERIENCE DU SERVICE DE GYNECOLOGIE-OBSTETRIQUE II DU CHU HASSAN II DE FES, A PROPOS DE CINQ CAS COLLIGES DURANT LANNEE 2017 - 2018

Portal hypertension on cirrhotic liver or not, when it is well supported; improves the vital prognosis in view of the hemorrhagic complications that it incurs. Thus, any woman before conception should consult her gastroenterologist in order to predispose to an armed follow-up in association with an obstetrician. Because the presence of a pregnancy in a woman with portal hypertension is a high-risk period, which can have a maternal-fetal prognosis. This risk can lead to maternal death, miscarriage, fetal death in utero or even prematurity or peri-and post-natal death. However, primary prevention is proposed in these patients, in order to act upstream on esophageal varices either by cardi-selective beta-blockers or by endoscopic ligation. The modalities of delivery will be discussed as appropriate. Although the lower lane is preferred, caesarean section also has its place, especially in purely obstetric indications. Thus the coalition of anesthesia staff, of neonatology in concomitance with gastroenterologists and obstetricians would be codified. For it will also be necessary to discuss the type of analgesia for which delivery route. To this end, we wanted to highlight our experience on the peculiarity of management of these pregnancy states collected within the gynecology-obstetrics department II of CHU Hassan II of Fes about five patients. A prospective study followed during the year 2017-2018. Two of the women were treated in delivery room with a strict minimum balance, while the other three were well followed with multidisciplinary care in collaboration with gastroenterologists, anesthetists and pediatricians