Non-selective beta blockers are well tolerated in pregnancy with portal hypertension

Guarino M, Cossiga V, Morisco F. The interpretation of liver function tests in pregnancy. Best Pract Res Clin Gastroenterol. 2020;44–45:101667.

Article  PubMed  Google Scholar 

Morton A, Laurie J, Hill J. Portal hypertension in pregnancy – concealed perils. Obstet Med. 2018;13:142–4.

Milić S, Tatalović T, Mikolašević I. Pre-existing liver disease in pregnancy: cirrhosis, autoimmune hepatitis and liver transplantation. Best Pract Res Clin Gastroenterol. 2020;44–45:101668.

Article  PubMed  Google Scholar 

Aggarwal N, Negi N, Aggarwal A, Bodh V, Dhiman RK. Pregnancy with portal hypertension. J Clin Exp Hepatol. 2014;4:163–71.

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

Pajor A, Lehoczky D. Pregnancy and extrahepatic portal hypertension. Review and report on the management. Gynecol Obstet Invest. 1990;30:193–7.

Russell MA, Craigo SD. Cirrhosis and portal hypertension in pregnancy. Semin Perinatol. 1998;22:156–65.

Pint D, Chung Y, Heneghan MA. Portal hypertension in pregnancy. Curr Opin Gastroenterol. 2025;41:110–5.

Benjaminov FS, Heathcote J. Liver disease in pregnancy. Am J Gastroenterol. 2004;99:2479–88.

Smith JL, Graham DY. Variceal hemorrhage: a critical evaluation of survival analysis. Gastroenterology. 1982;82 (5 Pt 1):968–73.

Bergman JEH, Lutke LR, Gans ROB, et al. Beta-blocker use in pregnancy and risk of specific congenital anomalies: a European case-malformed control study. Drug Saf. 2017;41:415–27.

de Bruin R, van Dalen SL, Franx SJ, et al. The risk for neonatal hypoglycemia and bradycardia after beta-blocker use during pregnancy or lactation: a systematic review and meta-analysis. Int J Environ Res Public Health. 2022;19:9616.

Kayser A, Beck E, Hoeltzenbein M, et al. Neonatal effects of intrauterine metoprolol/bisoprolol exposure during the second and third trimester: a cohort study with two comparison groups. J Hypertens. 2020;38:354–61.

Kumar N, Kumar P, Harris N, Monga R, Sampath V. Impact of maternal HbA1c levels ≤6% and race in nondiabetic pregnancies on birthweight and early neonatal hypoglycemia. J Pediatr. 2020;227:121-7.e3.

Mazkereth R, Maayan-Metzger A, Leibovitch L, Schushan-Eisen I, Morag I, Straus T. Short-term neonatal outcome among term infants after in-utero exposure to beta blockers. Isr Med Assoc J. 2019;21:724–7.

Ramlakhan KP, Roos-Hesselink JW, Basso T, et al. Perinatal outcomes after in-utero exposure to beta-blockers in women with heart disease: Data from the ESC EORP registry of pregnancy and cardiac disease (ROPAC). Int J Cardiol. 2024;1:132234.

Goel A, Elias JE, Eapen CE, Ramakrishna B, Elias E. Idiopathic non-cirrhotic intrahepatic portal hypertension (NCIPH)—newer insights into pathogenesis and emerging newer treatment options. J Clin Exp Hepatol. 2014;4:247–56.

de Franchis R, Bosch J, Garcia-Tsao G, Reiberger T, Ripoll C, Baveno VII Faculty. Baveno VII - Renewing consensus in portal hypertension. J Hepatol. 2022;4:959–74.

Article  Google Scholar 

Organization WH. WHO recommendations on interventions to improve preterm birth outcomes [Internet]. World Health Organization; 2015 [cited 2025 May 22]. Available from: https://iris.who.int/handle/10665/183037. Accessed 01.08.2025.

Sarin SK, Kumar A. Noncirrhotic portal hypertension. Clin Liver Dis. 2006;10:627–51, x.

Khanna R, Sarin SK. Noncirrhotic portal hypertension: current and emerging perspectives. Clin Liver Dis. 2019;23:781–807.

Goel A, Madhu K, Zachariah U, et al. A study of aetiology of portal hypertension in adults (including the elderly) at a tertiary centre in southern India. Indian J Med Res. 2013;137:922–7.

Simon EG, Joseph AJ, George B, et al. Aetiology of paediatric portal hypertension – experience of a tertiary care centre in South India. Trop Doct. 2009;39:42–4.

Giri S, Sahoo S. Pregnancy in patients with non-cirrhotic portal hypertension: a literature review. Rev Bras Ginecol Obstet. 2022;44:609–13.

Kochhar R, Kumar S, Goel RC, Sriram PV, Goenka MK, Singh K. Pregnancy and its outcome in patients with noncirrhotic portal hypertension. Dig Dis Sci. 1999;44:1356–61.

Keepanasseril A, Gupta A, Ramesh D, Kothandaraman K, Jeganathan YS, Maurya DK. Maternal-fetal outcome in pregnancies complicated with non-cirrhotic portal hypertension: experience from a Tertiary Centre in South India. Hepatol Int. 2020;14:842–9.

Subbaiah M, Kumar S, Roy KK, Sharma JB, Singh N. Extrahepatic portal-vein obstruction in pregnancy. Taiwan J Obstet Gynecol. 2015;54:394–7.

Aggarwal N, Chopra S, Raveendran A, Suri V, Dhiman RK, Chawla YK. Extra hepatic portal vein obstruction and pregnancy outcome: largest reported experience. J Obstet Gynaecol Res. 2011;37:575–80.

Andrade F, Shukla A, Bureau C, et al. Pregnancy in idiopathic non-cirrhotic portal hypertension: a multicentric study on maternal and fetal management and outcome. J Hepatol. 2018;69:1242–9.

Westbrook RH, Dusheiko G, Williamson C. Pregnancy and liver disease. J Hepatol. 2016;64:933–45.

Alexander V, Benjamin SJ, Subramani K, Sathyendra S, Goel A. Acute liver failure in pregnancy. Indian J Gastroenterol. 2024;43:325–37.

Shaheen AAM, Myers RP. The outcomes of pregnancy in patients with cirrhosis: a population-based study. Liver Int. 2010;30:275–83.

Gala AR, Surapaneni T, Aziz N, Kallur SD. A review of outcomes in pregnant women with portal hypertension. J Obstet Gynaecol India. 2018;68:447–51.

Puljic A, Salati J, Doss A, Caughey AB. Outcomes of pregnancies complicated by liver cirrhosis, portal hypertension, or esophageal varices. J Matern Fetal Neonatal Med. 2016;29:506–9.

Sarkar M, Brady CW, Fleckenstein J, et al. Reproductive health and liver disease: practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2021;73:318–65.

van der Slink LL, Scholten I, van Etten-Jamaludin FS, Takkenberg RB, Painter RC. Pregnancy in women with liver cirrhosis is associated with increased risk for complications: a systematic review and meta-analysis of the literature. BJOG. 2022;129:1644–52.

Ludvigsson JF, Lebwohl B, Ekbom A, et al. Outcomes of pregnancies for women undergoing endoscopy while they were pregnant: a nationwide cohort study. Gastroenterology. 2017;152:554–63.e9.

Research C for DE and. FDA Drug Safety Communication: FDA review results in new warnings about using general anesthetics and sedation drugs in young children and pregnant women. FDA [Internet]. 2019 Jun 18 [cited 2024 December 18]; Available from: https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-review-results-new-warnings-about-using-general-anesthetics-and. Accessed 01.08.2025.

Martinez A, Lakkimsetti M, Maharjan S, et al. Beta-blockers and their current role in maternal and neonatal health: a narrative review of the literature. Cureus. 2023;15:e44043. https://doi.org/10.7759/cureus.44043.

van de Vusse D, Mian P, Schoenmakers S, et al. Pharmacokinetics of the most commonly used antihypertensive drugs throughout pregnancy methyldopa, labetalol, and nifedipine: a systematic review. Eur J Clin Pharmacol. 2022;78:1763–76.

de Bruin R, van Dalen SL, Franx SJ, Simons SH, Flint RB, van den Bosch GE. Risk for neonatal hypoglycaemia and bradycardia after beta-blocker use during pregnancy or lactation: a systematic review and meta-analysis protocol. BMJ Open. 2022;12:e055292.

Duan L, Ng A, Chen W, Spencer HT, Lee M. Beta-blocker subtypes and risk of low birth weight in newborns. J Clin Hypertens. 2018;20:1603–9.

Williamson C, Nana M, Poon L, et al. EASL Clinical Practice Guidelines on the management of liver diseases in pregnancy. J Hepatol. 2023;79:768–828.

Bratton S, Taylor MK, Cortez P, Schiattarella A, Fochesato C, Sisti G. Does atenolol use during pregnancy cause small for gestational age neonates? A meta-analysis. J Perinat Med. 2024;52:858–62.

Alrabadi B, Al Kayed HA, Alshujaieh N, Saadeh A, Khanfar R. Impact of beta-blocker therapy on pregnant women with long QT syndrome: a systematic review. Cureus. 2024;16:e71678.

Shukla A, Rockey DC, Kamath PS, et al. Non-cirrhotic portal fibrosis/idiopathic portal hypertension: APASL recommendations for diagnosis and management. Hepatol Int. 2024;18:1684–711.

Comments (0)

No login
gif