{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:01:23Z","timestamp":1790694083083,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate risks of pregnancy and birth in patients with peripheral vascular malformations (VMs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Nationwide cross\u2010sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary referral centre and Dutch national patient organisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Women aged \u2265\u200915\u2009years diagnosed with peripheral VM of any subtype or anatomical location.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients were invited to complete a comprehensive questionnaire about obstetric history and VM\u2010related symptoms during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Prevalence of complications, specifically worsening of VM\u2010related symptoms during pregnancy, deep venous thrombosis (DVT), pulmonary embolism (PE) and postpartum haemorrhage (PPH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Two\u2010hundred\u2010six women completed the questionnaire. Among 108 patients, 248 pregnancies and 204 births were reported; 98 patients were nulligravid. DVT and PE occurred in 2.5% and 0.5% of total pregnancies, respectively and only occurred in patients with extensive VMs (&gt;\u200930\u2009cm) involving at least the lower extremities (predominantly Klippel\u2010Trenaunay). PPH occurred in 19.6% of births, including in 63.6% of those with uterine involvement and 47.8% with genital involvement of the VM. VM\u2010related symptom worsening and volume increase during pregnancy occurred in 47.6% and 45.4% of patients, respectively. In multivariable regression, AVM subtype (OR 4.0, 95% CI 1.0\u201315.1), genital region involvement (OR 4.6, 95% CI 1.5\u201313.8), and a history of puberty\u2010related symptom progression (OR 2.6, 95% CI 1.1\u20136.2) were independently associated with VM\u2010related symptom worsening during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Women with VMs appear to have a significant risk of PPH and worsening of VM\u2010related symptoms during pregnancy, especially if the genital region is involved. Increased thromboembolic risk appears confined to patients with extensive VMs involving the lower extremities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70205","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:07:30Z","timestamp":1773004050000},"page":"1493-1501","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Complications of Pregnancy and Birth in Women With Vascular Malformations: A Nationwide Cross\u2010Sectional Study"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9405-8291","authenticated-orcid":false,"given":"Delano J.","family":"de Oliveira Marreiros","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive and Hand Surgery Amsterdam University Medical Centres  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max M.","family":"Lokhorst","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Hand Surgery Amsterdam University Medical Centres  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie E. R.","family":"Horbach","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Hand Surgery Amsterdam University Medical Centres  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merel L. E.","family":"Stor","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Hand Surgery Amsterdam University Medical Centres  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"van Hout","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Hand Surgery Amsterdam University Medical Centres  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor E. A.","family":"Gerdes","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine Amsterdam University Medical Centres  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wessel","family":"Ganzevoort","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Amsterdam University Medical Centres  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantal M. A. M.","family":"van der Horst","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Hand Surgery Amsterdam University Medical Centres  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2006.038885"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2014.06.016"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-3673"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14698"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2015.10.045"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.16029"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2025.05.036"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.06.012"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199809010-00006"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-023-01436-5"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2018.05.001"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/1753495X17719181"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1155\/2010\/706850"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.5468\/ogs.2014.57.2.155"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-402"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtha.2025.03.009"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1201\/9780429258589"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12950"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00682-6"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13520"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2019.04.018"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1563721"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crwh.2020.e00260"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.148"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31824ec3fb"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/MS9.0000000000000507"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.70205","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1471-0528.70205","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.70205","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:46:27Z","timestamp":1790693187000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.70205"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,7]]},"references-count":26,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/1471-0528.70205"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.70205","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,7]]},"assertion":[{"value":"2025-10-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}