Pregnancy in Liver Cirrhosis
Assessment of Maternal and Fetal Risks in Eleven Patients and Review of the ManagementPajor A. · Lehoczky D.
2nd Department of Obstetrics and Gynecology, and 1st Department of Medicine, Semmelweis Medical University, Budapest, Hungary
Eleven patients with liver cirrhosis who had a pregnancy between 1974 and 1992 are reported. Prior to pregnancy 2 patients were splenectomized, 1 of them also had an unsuccessful mesocaval shunt and therefore underwent sclerotherapy. Furthermore, 3 patients were managed by injection sclerotherapy, 6 patients had episodes of hepatocellular failure and 5 had signs of hypersplenism. Gastrointestinal hemorrhage associated with pregnancy was noted in 6 patients. Jaundice was encountered in 2 patients, a raised bilirubin level in 3, ascites in 3, impairment of the synthetic liver function in 5, thrombocytopenia in 8, hemorrhagic diathesis in 5, and infectious puerperal complication in 5 patients. Esophageal sclerotherapy was used in 5 and transfusion in 6 patients. Of 12 births, 6 newborns were small-for-date and 1 of them died. Three neonates were preterm. Fetal wastage did not occur. The present data suggest that gastrointestinal hemorrhage in liver cirrhosis contributes to developing fetal growth retardation; cirrhotic patients can be prepared for pregnancy and the hematemesis during pregnancy can successfully be managed by esophageal sclerotherapy.
© 1994 S. Karger AG, Basel
Dr. Attila Pajor, 2nd Department of Obstetrics and Gynecology, Semmelweis Medical University, Üllöi ut 78/A (II.Nöi Klinika) H-1082 Budapest (Hungary)
Received: April 26, 1993
Accepted: September 27, 1993
Published online: March 01, 2010
Number of Print Pages : 6
Gynecologic and Obstetric Investigation
Vol. 38, No. 1, Year 1994 (Cover Date: 1994)
Journal Editor: D'Hooghe T. (Leuven)
ISSN: 0378-7346 (Print), eISSN: 1423-002X (Online)
For additional information: http://www.karger.com/GOI