Pregnancy and liver disease.

Steven, Michelle

doi:10.1136/gut.22.7.592

Cited by 119 publications

(38 citation statements)

References 140 publications

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“…2,17,18 However, for women with cirrhosis who do become pregnant, the risk of maternal and fetal complications has been reported in up to 50% of cases and maternal mortality has been reported in up to 10% of cases. 2,19,20 …”

mentioning

confidence: 99%

Recent trends in hepatic diseases during pregnancy in the United States, 2002–2010

Ellington

Flowers

Legardy-Williams

et al. 2015

American Journal of Obstetrics and Gynecology

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OBJECTIVE While pregnancy-related severe liver disorders are rare, when they occur morbidity and mortality rates are increased for mothers and infants. The objective of this study was to examine the prevalence and trends of hepatic diseases during pregnancy hospitalizations from 2002 through 2010 in the United States. STUDY DESIGN Hospital discharge data were obtained from the Nationwide Inpatient Sample, the largest all-payer hospital inpatient care database in the United States that provides nationally representative estimates. Pregnancy hospitalizations with the following diagnoses were identified: hepatitis B, hepatitis C, gallbladder disease/cholelithiasis, liver disorders of pregnancy, chronic/alcohol-related liver disease, biliary tract disease, and HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome. Age, insurance status, hospital location, and hospital region were compared among women with and without hepatic diseases using a χ2 test. Trends in rates of pregnancy hospitalizations and mean charges were analyzed using multivariable logistic and linear regression, respectively. RESULTS From 2002 through 2010 there were an estimated 41,479,358 pregnancy hospitalizations in the United States. Gallbladder disease and liver disorders of pregnancy were the most common hepatic diseases (rates = 7.18 and 4.65/1000 pregnancy hospitalizations, respectively). Adjusted rates and mean charges significantly increased for all hepatic diseases during pregnancy over the study period. All hepatic diseases were associated with significantly higher charges compared to all pregnancy hospitalizations. HELLP syndrome was associated with the highest mean charges. CONCLUSION This large study among a representative sample of the US population provides valuable information that can aid policy planning and management of these hepatic diseases during pregnancy in the United States.

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mentioning

confidence: 99%

Recent trends in hepatic diseases during pregnancy in the United States, 2002–2010

Ellington

Flowers

Legardy-Williams

et al. 2015

American Journal of Obstetrics and Gynecology

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“…12 Rupture of splenic artery aneurysm, although uncommon, could also present in pregnant women with portal hypertension. Hepatic encephalopathy also remains a concern and cause of death in this setting.…”

Section: Pulse Volume 5(1)2011mentioning

confidence: 99%

“…8 Maternal mortality rate as high as 10.5% has been described in this group. 12 Maternal prognosis depends on the degree of hepatic dysfunction during pregnancy rather than its cause. 13 Portal hypertension worsens during pregnancy because of increased blood volume and flow.…”

Section: Pulse Volume 5(1)2011mentioning

confidence: 99%

Miracle Happening In Life: Intra-Abdominal Haemorrhage in Cirrhosis in Pregnancy Managed By Massive Blood Transfusion

Begum¹,

Begum

Rahman

2014

PULSE

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Pregnancy is a rare event in patients with cirrhosis. Recent improvements in the treatment of chronic liver disease have resulted in higher conception rates and more successful pregnancy outcomes. Still pregnancy in cirrhosis is associated with high incidence of fetal loss as well as higher maternal mortality both during pregnancy and in the post-partum period. In this paper we described a case of a successful pregnancy in a young woman with advanced cirrhosis facing life threatening condition in her last trimester and perioperative period.

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“…The prognosis in association with pregnancy is uniformly bad [40], It is commonly described in the puerperium [78], The usual clinical presentation is acute ab dominal pain, hepatomegaly and ascites. He patic venography is diagnostic.…”

Section: Budd-chiari Syndromementioning

confidence: 99%

“…The cause is unknown but a popular the ory is that there is a disturbance in the balance between prostacyclin (relative deficiency) and thromboxane (relative increase) [39], The se verer the hypertension, the more likely (25% [1], 50% [40,41]) is the liver to be affected. Although the changes in liver function are variable, they usually parallel the clinical state and severity of the hypertension [1,41], In severe cases with hepatic involvement, symp toms of right upper quadrant pain, nausea and vomiting are usually present.…”

Section: Hypertensive Disease In Pregnancymentioning

confidence: 99%

Gastro-Intestinal Crises during Pregnancy

Smoleniec

James²

1993

Dig Dis

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In general pregnancy is not associated with an increase in the incidence of gastro-intestinal (GI) conditions, but it is associated with an increase in the severity of these conditions. This is largely due to a delay in making the diagnosis. Delay is caused by a combination of factors. These include mimicry of symptoms and signs with pregnancy-related conditions, a change in the usual clinical presentation, reluctance to use radiological diagnostic aids and a higher threshold for performing invasive investigative procedures. However before resorting to invasive investigations, it is imperative that appropriate non-invasive investigations are performed and evaluated first. This is especially relevant to liver conditions in pregnancy which can present with abdominal pain. Optimal management of GI conditions in pregnancy requires both surgeons and obstetricians to be aware of the problems of diagnosis, communicate promptly and investigate without delay in order to make a diagnosis and avert a GI crisis. This article discusses the clinical presentation, diagnosis and management of the common GI conditions occurring in pregnancy.

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Pregnancy and liver disease.

Cited by 119 publications

References 140 publications

Recent trends in hepatic diseases during pregnancy in the United States, 2002–2010

Recent trends in hepatic diseases during pregnancy in the United States, 2002–2010

Miracle Happening In Life: Intra-Abdominal Haemorrhage in Cirrhosis in Pregnancy Managed By Massive Blood Transfusion

Gastro-Intestinal Crises during Pregnancy

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