UpToDate
Official reprint from UpToDate®
www.uptodate.com ©2016 UpToDate®

Pregnancy in women with pre-existing chronic liver disease

Authors
Richard H Lee, MD
Tram T Tran, MD
Section Editors
Sanjiv Chopra, MD, MACP
Charles J Lockwood, MD, MHCM
Deputy Editor
Anne C Travis, MD, MSc, FACG, AGAF

INTRODUCTION

Liver disease in pregnant women can be seen in three general settings:

The patient has liver disease induced by pregnancy, such as:

Acute fatty liver of pregnancy (see "Acute fatty liver of pregnancy")

Intrahepatic cholestasis of pregnancy (see "Intrahepatic cholestasis of pregnancy")

Hyperemesis gravidarum (see "Clinical features and evaluation of nausea and vomiting of pregnancy" and "Treatment and outcome of nausea and vomiting of pregnancy")

                  

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Nov 2016. | This topic last updated: Thu Mar 03 00:00:00 GMT+00:00 2016.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2016 UpToDate, Inc.
References
Top
  1. Varma RR. Course and prognosis of pregnancy in women with liver disease. Semin Liver Dis 1987; 7:59.
  2. Tan J, Surti B, Saab S. Pregnancy and cirrhosis. Liver Transpl 2008; 14:1081.
  3. Schweitzer IL, Peters RL. Pregnancy in hepatitis B antigen positive cirrhosis. Obstet Gynecol 1976; 48:53S.
  4. Hillemanns P, Knitza R, Müller-Höcker J. Rupture of splenic artery aneurysm in a pregnant patient with portal hypertension. Am J Obstet Gynecol 1996; 174:1665.
  5. Cheng YS. Pregnancy in liver cirrhosis and/or portal hypertension. Am J Obstet Gynecol 1977; 128:812.
  6. Schreyer P, Caspi E, El-Hindi JM, Eshchar J. Cirrhosis--pregnancy and delivery: a review. Obstet Gynecol Surv 1982; 37:304.
  7. Westbrook RH, Yeoman AD, O'Grady JG, et al. Model for end-stage liver disease score predicts outcome in cirrhotic patients during pregnancy. Clin Gastroenterol Hepatol 2011; 9:694.
  8. Soto-Albors CE, Rayburn WF, Taylor L, Musselman M. Portal hypertension and hypersplenism in pregnancy secondary to chronic schistosomiasis. A case report. J Reprod Med 1984; 29:345.
  9. Britton RC. Pregnancy and esophageal varices. Am J Surg 1982; 143:421.
  10. Pergam SA, Wang CC, Gardella CM, et al. Pregnancy complications associated with hepatitis C: data from a 2003-2005 Washington state birth cohort. Am J Obstet Gynecol 2008; 199:38.e1.
  11. Jaffery T, Tariq N, Ayub R, Yawar A. Frequency of hepatitis C in pregnancy and pregnancy outcome. J Coll Physicians Surg Pak 2005; 15:716.
  12. Floreani A, Paternoster D, Zappala F, et al. Hepatitis C virus infection in pregnancy. Br J Obstet Gynaecol 1996; 103:325.
  13. Latt NC, Spencer JD, Beeby PJ, et al. Hepatitis C in injecting drug-using women during and after pregnancy. J Gastroenterol Hepatol 2000; 15:175.
  14. Di Martino V, Lebray P, Myers RP, et al. Progression of liver fibrosis in women infected with hepatitis C: long-term benefit of estrogen exposure. Hepatology 2004; 40:1426.
  15. Conte D, Fraquelli M, Prati D, et al. Prevalence and clinical course of chronic hepatitis C virus (HCV) infection and rate of HCV vertical transmission in a cohort of 15,250 pregnant women. Hepatology 2000; 31:751.
  16. Wegmann TG, Lin H, Guilbert L, Mosmann TR. Bidirectional cytokine interactions in the maternal-fetal relationship: is successful pregnancy a TH2 phenomenon? Immunol Today 1993; 14:353.
  17. Gervais A, Bacq Y, Bernuau J, et al. Decrease in serum ALT and increase in serum HCV RNA during pregnancy in women with chronic hepatitis C. J Hepatol 2000; 32:293.
  18. Fontaine H, Nalpas B, Carnot F, et al. Effect of pregnancy on chronic hepatitis C: a case-control study. Lancet 2000; 356:1328.
  19. Ohto H, Terazawa S, Sasaki N, et al. Transmission of hepatitis C virus from mothers to infants. The Vertical Transmission of Hepatitis C Virus Collaborative Study Group. N Engl J Med 1994; 330:744.
  20. Zanetti AR, Tanzi E, Paccagnini S, et al. Mother-to-infant transmission of hepatitis C virus. Lombardy Study Group on Vertical HCV Transmission. Lancet 1995; 345:289.
  21. Thaler MM, Park CK, Landers DV, et al. Vertical transmission of hepatitis C virus. Lancet 1991; 338:17.
  22. Mast EE, Hwang LY, Seto DS, et al. Risk factors for perinatal transmission of hepatitis C virus (HCV) and the natural history of HCV infection acquired in infancy. J Infect Dis 2005; 192:1880.
  23. Ghamar Chehreh ME, Tabatabaei SV, Khazanehdari S, Alavian SM. Effect of cesarean section on the risk of perinatal transmission of hepatitis C virus from HCV-RNA+/HIV- mothers: a meta-analysis. Arch Gynecol Obstet 2011; 283:255.
  24. Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease. MMWR Morb Mortal Wkly Rep 1998; 47:29.
  25. Feucht HH, Zollner B, Polywka S, Laufs R. Vertical transmission of hepatitis G. Lancet 1996; 347:615.
  26. Whelton MJ, Sherlock S. Pregnancy in patients with hepatic cirrhosis. Management and outcome. Lancet 1968; 2:995.
  27. Olsson R, Tysk C, Aldenborg F, Holm B. Prolonged postpartum course of intrahepatic cholestasis of pregnancy. Gastroenterology 1993; 105:267.
  28. Rabinovitz M, Appasamy R, Finkelstein S. Primary biliary cirrhosis diagnosed during pregnancy. Does it have a different outcome? Dig Dis Sci 1995; 40:571.
  29. Poupon R, Chrétien Y, Chazouillères O, Poupon RE. Pregnancy in women with ursodeoxycholic acid-treated primary biliary cirrhosis. J Hepatol 2005; 42:418.
  30. Heathcote EJ. Management of primary biliary cirrhosis. The American Association for the Study of Liver Diseases practice guidelines. Hepatology 2000; 31:1005.
  31. Wellge BE, Sterneck M, Teufel A, et al. Pregnancy in primary sclerosing cholangitis. Gut 2011; 60:1117.
  32. Ludvigsson JF, Bergquist A, Ajne G, et al. A population-based cohort study of pregnancy outcomes among women with primary sclerosing cholangitis. Clin Gastroenterol Hepatol 2014; 12:95.
  33. Cobey FC, Salem RR. A review of liver masses in pregnancy and a proposed algorithm for their diagnosis and management. Am J Surg 2004; 187:181.
  34. Dokmak S, Paradis V, Vilgrain V, et al. A single-center surgical experience of 122 patients with single and multiple hepatocellular adenomas. Gastroenterology 2009; 137:1698.
  35. Wilson CH, Manas DM, French JJ. Laparoscopic liver resection for hepatic adenoma in pregnancy. J Clin Gastroenterol 2011; 45:828.
  36. Noels JE, van Aalten SM, van der Windt DJ, et al. Management of hepatocellular adenoma during pregnancy. J Hepatol 2011; 54:553.
  37. Weimann A, Mössinger M, Fronhoff K, et al. Pregnancy in women with observed focal nodular hyperplasia of the liver. Lancet 1998; 351:1251.
  38. Scott LD, Katz AR, Duke JH, et al. Oral contraceptives, pregnancy, and focal nodular hyperplasia of the liver. JAMA 1984; 251:1461.
  39. Friedlaender P, Osler M. Icterus and pregnancy. Am J Obstet Gynecol 1967; 97:894.
  40. Cohen L, Lewis C, Arias IM. Pregnancy, oral contraceptives, and chronic familial jaundice with predominantly conjugated hyperbilirubinemia (Dubin-Johnson syndrome). Gastroenterology 1972; 62:1182.
  41. Romero R, Reece EA, Riely C, Hobbins JC. Arteriohepatic dysplasia in pregnancy. Am J Obstet Gynecol 1983; 147:108.
  42. Rajka G. Pregnancy and porphyria cutanea tarda. Acta Derm Venereol 1984; 64:444.
  43. Brodie MJ, Moore MR, Thompson GG, et al. Pregnancy and the acute porphyrias. Br J Obstet Gynaecol 1977; 84:726.
  44. Kanaan C, Veille JC, Lakin M. Pregnancy and acute intermittent porphyria. Obstet Gynecol Surv 1989; 44:244.
  45. Tollånes MC, Aarsand AK, Sandberg S. Excess risk of adverse pregnancy outcomes in women with porphyria: a population-based cohort study. J Inherit Metab Dis 2011; 34:217.
  46. Rautou PE, Angermayr B, Garcia-Pagan JC, et al. Pregnancy in women with known and treated Budd-Chiari syndrome: maternal and fetal outcomes. J Hepatol 2009; 51:47.
  47. Douglas NC, Shah M, Sauer MV. Fertility and reproductive disorders in female solid organ transplant recipients. Semin Perinatol 2007; 31:332.
  48. Nagy S, Bush MC, Berkowitz R, et al. Pregnancy outcome in liver transplant recipients. Obstet Gynecol 2003; 102:121.
  49. Radomski JS, Moritz MJ, Muñoz SJ, et al. National Transplantation Pregnancy Registry: analysis of pregnancy outcomes in female liver transplant recipients. Liver Transpl Surg 1995; 1:281.
  50. Armenti VT, Radomski JS, Moritz MJ, et al. Report from the National Transplantation Pregnancy Registry (NTPR): outcomes of pregnancy after transplantation. Clin Transpl 1997; :101.
  51. Patapis P, Irani S, Mirza DF, et al. Outcome of graft function and pregnancy following liver transplantation. Transplant Proc 1997; 29:1565.
  52. Scantlebury V, Gordon R, Tzakis A, et al. Childbearing after liver transplantation. Transplantation 1990; 49:317.
  53. Ville Y, Fernandez H, Samuel D, et al. Pregnancy in liver transplant recipients: course and outcome in 19 cases. Am J Obstet Gynecol 1993; 168:896.
  54. Rayes N, Neuhaus R, David M, et al. Pregnancies following liver transplantation--how safe are they? A report of 19 cases under cyclosporine A and tacrolimus. Clin Transplant 1998; 12:396.
  55. Wu A, Nashan B, Messner U, et al. Outcome of 22 successful pregnancies after liver transplantation. Clin Transplant 1998; 12:454.
  56. Raakow R, Neuhaus R, Büscher U, et al. Parenthood following liver transplantation. Transplant Proc 2001; 33:1450.
  57. Kubo S, Uemoto S, Furukawa H, et al. Pregnancy outcomes after living donor liver transplantation: results from a Japanese survey. Liver Transpl 2014; 20:576.
  58. Jain A, Venkataramanan R, Fung JJ, et al. Pregnancy after liver transplantation under tacrolimus. Transplantation 1997; 64:559.
  59. Roberts M, Brown AS, James OF, Davison JM. Interpretation of cyclosporin A levels in pregnancy following orthoptic liver transplantation. Br J Obstet Gynaecol 1995; 102:570.
  60. Keller F, Griesshammer M, Häussler U, et al. Pregnancy and renal failure: the case for application of dosage guidelines. Drugs 2001; 61:1901.
  61. Laifer SA, Darby MJ, Scantlebury VP, et al. Pregnancy and liver transplantation. Obstet Gynecol 1990; 76:1083.
  62. Merritt WT, Dickstein R, Beattie C, et al. Liver transplantation during pregnancy: anesthesia for two procedures in the same patient with successful outcome of pregnancy. Transplant Proc 1991; 23:1996.
  63. Friedman E, Moses B, Engelberg S, et al. Malignant insulinoma with hepatic failure complicating pregnancy. South Med J 1988; 81:86.
  64. Kato T, Nery JR, Morcos JJ, et al. Successful living related liver transplantation in an adult with fulminant hepatic failure. Transplantation 1997; 64:415.