title: Successful pregnancy with autoimmune cirrhosis.
abstract: Pregnancy with liver cirrhosis is a rare and dangerous event that exposes mother and fetus to potentially lethal risks. During pregnancy, hepatic decompensation could suffice and the development of hepatic failure and encephalopathy could occur. The incidence of obstetric complications is also increased with a high rate of pre-eclampsia, postpartum bleeding, preterm delivery and stillbirth. We report a case of a 27-year-old woman with autoimmune hepatitis and liver cirrhosis complicated by splenomegaly, oesophageal varices and severe thrombocytopaenia. During pregnancy, close clinical and analytical surveillance was performed. She was medicated with corticosteroids, azathioprine and propranolol. At the 25th week of gestation, an upper gastrointestinal endoscopy was performed to control oesophageal varices. This patient had an uneventful pregnancy until 37 weeks. At 37th week of gestation, after spontaneous rupture of membranes, signs of acute fetal distress were observed, and an urgent caesarean was performed. Good neonatal and maternal outcomes were achieved.
authors.affiliation: Department of Obstetrics, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: António
authors.initials: A
authors.lastname: Braga
authors.affiliation: Department of Obstetrics, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: Jorge
authors.initials: J
authors.lastname: Braga
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D002585:Cesarean Section; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000628:therapy*; D005260:Female; D005316:Fetal Distress; D005323:Fetal Monitoring; D019693:Hepatitis, Autoimmune / Q000150:complications* / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D008103:Liver Cirrhosis / Q000150:complications* / Q000276:immunology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000276:immunology / Q000628:therapy*; D011256:Pregnancy Outcome; D011433:Propranolol / Q000627:therapeutic use; D013163:Splenomegaly / Q000150:complications* / Q000276:immunology
chemical_list: D000305:Adrenal Cortex Hormones; D000959:Antihypertensive Agents; D007166:Immunosuppressive Agents; D011433:Propranolol; D001379:Azathioprine
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