title: Outcomes of pregnancies complicated by liver cirrhosis, portal hypertension, or esophageal varices.
abstract: OBJECTIVE
  To evaluate pregnancy outcomes in women with liver cirrhosis, portal hypertension, or esophageal varices.
  
  
  METHODS
  We analyzed a retrospective cohort of 2,284,218 pregnancies in 2005-2009 recorded in the California Birth Registry database. Utilizing ICD-9 codes we analyzed the following outcomes for liver cirrhosis, portal hypertension, or esophageal varices in pregnancy: preeclampsia (PET), preterm delivery (PTD; <37 weeks), cesarean section, low birth weight (LBW; <2500 g), small for gestational age (SGA; <10th percentile), neonatal death (NND), and postpartum hemorrhage (PPH).
  
  
  RESULTS
  Cirrhosis in pregnancy conferred an increased risk of PET, PTD, CS in multiparous women, LBW, and NND. Portal hypertension in pregnancy was associated with PTD, LBW, NND, and PPH. Non-bleeding esophageal varices in pregnancy were not associated with the outcomes assessed in a statistically significant manner. One case of bleeding esophageal varices was observed, resulting in PTD with a LBW infant. There were three cases of concomitant portal hypertension or concomitant esophageal varices with cirrhosis in pregnancy.
  
  
  CONCLUSIONS
  Pregnancy in women with concomitant liver cirrhosis, portal hypertension, or esophageal varices can be successful. However, pregnancy outcomes are worse and may warrant closer antenatal monitoring and patient counseling. Cirrhosis in pregnancy with concomitant portal hypertension or esophageal varices is rare.
authors: a Department of Reproductive Medicine , University of California , San Diego , CA , USA and.
authors: Anela
authors: A
authors: Puljic
authors: b Department of Obstetrics & Gynecology , Oregon Health & Science University , Portland , OR , USA.
authors: Jennifer
authors: J
authors: Salati
authors: b Department of Obstetrics & Gynecology , Oregon Health & Science University , Portland , OR , USA.
authors: Amy
authors: A
authors: Doss
authors: b Department of Obstetrics & Gynecology , Oregon Health & Science University , Portland , OR , USA.
authors: Aaron B
authors: AB
authors: Caughey
mesh_terms: D004932:Esophageal and Gastric Varices; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D012189:Retrospective Studies
keywords: Esophageal varices; liver cirrhosis; portal hypertension; pregnancy outcomes