Review article: chronic liver disease and pregnancy

Research output: Contribution to journalArticlepeer-review

Authors

  • Rosemary E. Faulkes
  • Ellen Knox
  • Tracey Johnston
  • Fiona Thompson
  • James Ferguson

External organisations

  • Liver Unit; Queen Elizabeth Hospital Birmingham; Edgbaston Birmingham UK
  • Centre for Liver Research; Institute of Immunology and Inflammation, and National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre; The Medical School; University of Birmingham; Birmingham UK
  • Birmingham Childrens and Womens Hospital

Abstract

Background
The prevalence of chronic liver disease in women of child bearing age is increasing, leading to a higher incidence of pregnancy in this cohort. Chronic medical conditions have a significant adverse effect on maternal morbidity and mortality. To date, reviews on this topic have been written either from a hepatology or obstetrics viewpoint, and no specific guidelines are available solely for the management of chronic liver disease in pregnancy.

Aims
To produce a comprehensive review on the clinical management of women with chronic liver disease during pregnancy, addressing the risks of pregnancy to mother and child, how these risks can be ameliorated, and what additional considerations are required for management of chronic liver disease in pregnancy.

Methods
Data were collected up to May 2020 from the biomedical database PubMed, national and international guidelines in gastroenterology and hepatology.

Results
During pregnancy, women with cirrhosis are more likely to develop decompensated disease, worsening of portal hypertension, and to deliver premature infants.

Conclusions
The risks associated with pregnancy can be ameliorated by advanced planning, assessing risk using the model for end stage liver disease score and risk reduction through varices screening. A multidisciplinary approach is paramount in order to minimise complications and maximise the chance of a safe pregnancy and birth for mother and baby.

Details

Original languageEnglish
Pages (from-to)420-429
JournalAlimentary Pharmacology & Therapeutics
Volume52
Issue number3
Early online date29 Jun 2020
Publication statusPublished - 1 Aug 2020