Open AccessManagement of pregnancy in women with cirrhosis
Author(s) -
Rahim Mussarat N.,
Pirani Tasneem,
Williamson Catherine,
Heneghan Michael A.
Publication year - 2021
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640620977034
Subject(s) - medicine , pregnancy , cirrhosis , decompensation , obstetrics , maternal morbidity , disease , fetus , intensive care medicine , gynecology , genetics , biology
Although pregnancy is rare in women with cirrhosis, it is increasingly prevalent in an era of modern assisted conception techniques and improved awareness, monitoring and management of underlying liver disease. After overcoming the difficulties of subfertility and becoming pregnant, women undergo a ‘high‐risk’ pregnancy which can be complicated by variceal haemorrhage (≤50%) and hepatic decompensation (≤25%). Management of these complications are similar to non‐pregnant individuals. However, there are a few caveats to consider. These pregnancies are associated with adverse maternal and foetal outcomes, such as mortality (0%–8%) and prematurity (19%–67%) in the newborn, and mortality (0%–14%), pregnancy‐induced hypertension (5%–22%) and post‐partum haemorrhage (5%–45%) in the mother. Pre‐pregnancy counselling, use of predictive scores and appropriate variceal screening during pregnancy can stratify patients and improve outcomes. This review focusses on the complications that can occur during pregnancy in women with cirrhosis.