Problems during and after pregnancy in female patients with biliary atresia.
OBJECTIVE
Advances in the management for biliary atresia (BA) have improved the prognosis and has greatly increased the number of long-term survivors. Even the long-term survivors, however, still face some problems. This retrospective review was performed to assess pregnancy-associated issues in long-term survivors after surgery for BA.


METHODS
Of 55 patients with BA surviving for 16 years or more without liver transplantation, 9 patients have experienced pregnancy and delivery. Clinical courses, the outcome of pregnancy and delivery, and current statuses were retrospectively evaluated from their clinical records.


RESULTS
The study revealed 14 pregnancies and 11 deliveries. Before pregnancy, no patient showed visible jaundice, but 6 patients had some complications such as episodes of cholangitis and portal hypertension. Two of the patients had both conditions and 2 others developed visible jaundice after pregnancy. One intrauterine fetal death occurred.


CONCLUSIONS
Our retrospective review suggests that the previously mentioned conditions can be risk factor for cholangitis and gastrointestinal bleeding during or after pregnancy but are not considered to be contraindications for pregnancy and delivery. Complications can occur with pregnancy even during the normal course. Thus, careful observation is recommended.
Sasaki
Hideyuki
H
Department of Pediatric Surgery, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan. h-sasaki@ped-surg.med.tohoku.ac.jp
Nio
Masaki
M
Hayashi
Yutaka
Y
Ishii
Tomohiro
T
Sano
Nobuyuki
N
Ohi
Ryoji
R
D000328:Adult; D001656:Biliary Atresia / Q000150:complications*; D002761:Cholangitis / Q000209:etiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D012189:Retrospective Studies