Pregnancy and delivery after liver transplantation.
OBJECTIVE
According to statistics, women constitute one-third of all liver recipients and approximately 75% of female recipients are of reproductive age. Successful liver transplantation in these patients results in the restoration of menstrual function and fertility. The aim of this study was to assess the course of pregnancy and delivery in liver-transplanted women.


METHODS
We retrospectively analyzed data of 138 liver-transplanted women, aged from 18 to 63 years, who underwent regular gynecological evaluations. Among 77 patients of reproductive age, 11 women conceived and delivered babies.


RESULTS
All patients have successfully delivered. The mean gestation age at delivery was 36.5 weeks. All neonates were delivered in a good state with no congenital abnormalities. Common pregnancy complications were preterm birth, anemia, intrahepatic cholestasis, and infection. In 1 case, graft rejection was observed due to willful discontinuation of immunosuppressive therapy. Two spontaneous vaginal deliveries and 9 caesarean sections were performed. All caesarean sections were performed for obstetrical indications: fetal intrauterine asphyxia (n = 4), breech presentation (n = 2), threatening intrauterine infection (n = 2), and preterm twin delivery (n = 1).


CONCLUSIONS
High-risk pregnancies in liver-transplanted women are generally associated with good outcomes, although an increased rate of preterm labor, intrauterine infections, anemia, and cholestasis were observed. Pregnancy did not seem to impair graft function or accelerate rejection in patients receiving immunosuppressive therapy.
Jabiry-Zieniewicz
Z
Z
First Department of Obstetrics and Gynecology, The Medical University of Warsaw, Warsaw, Poland.
Cyganek
A
A
Luterek
K
K
Bobrowska
K
K
Kamiński
P
P
Ziółkowski
J
J
Zieniewicz
K
K
Krawczyk
M
M
D000328:Adult; D002585:Cesarean Section; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D016031:Liver Transplantation; D011247:Pregnancy; D011248:Pregnancy Complications / Q000145:classification*; D011256:Pregnancy Outcome; D012189:Retrospective Studies