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Chapter 45 - Pregnancy after Liver Transplantation

from Section 7 - Hepato-Renal and Gastrointestinal Conditions in Pregnancy

Published online by Cambridge University Press:  23 February 2023

By
Neha Agrawal ,
Amira El-Messidi  and
Maged Peter Ghali
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

A 29-year-old primigravida is a recipient of a liver transplant. She is referred by her primary care provider to your high-risk obstetrics clinic for consultation and prenatal care of a spontaneous intrauterine singleton pregnancy at 12+0 weeks’ gestation by dating sonogram. The patient takes prenatal vitamins and has no obstetric complaints.

Keywords

Liver transplantation, pregnancyComorbiditiesInvestigations, prenatalPerinatal risks, complications, maternal-fetal morbidity, adverse outcomeImmunosuppressive treatment, pharmacology, tacrolimus, prednisone, corticosteroidsAntenatal managementLiver enzymes, transaminases, differential diagnosisNonalcoholic steatohepatitisObstetric deliveryVaginal delivery, maternal corticosteroid stress dosesTransjugular intrahepatic portosystemic shunt (TIPS)Contraception
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 573 - 583
Publisher: Cambridge University Press
Print publication year: 2023

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References

Suggested Readings

Blume, C, Pischke, S, von Versen-Höynck, F, et al. Pregnancies in liver and kidney transplant recipients: a review of the current literature and recommendation. Best Pract Res Clin Obstet Gynaecol. 2014 Nov;28(8):1123–1136.Google Scholar
Jabiry-Zieniewicz, Z, Dabrowski, FA, Pietrzak, B, et al. Pregnancy in the liver transplant recipient. Liver Transpl. 2016 Oct;22(10):1408–1417.CrossRefGoogle ScholarPubMed
Marson, EJ, Kamarajah, SK, Dyson, JK, et al. Pregnancy outcomes in women with liver transplants: systematic review and meta-analysis. HPB (Oxford). 2020 Aug;22(8):1102–1111.Google Scholar
National Guideline Alliance (UK). Intrapartum Care for Women with Existing Medical Conditions or Obstetric Complications and Their Babies. London: National Institute for Health and Care Excellence (UK); 2019.Google Scholar
Parhar, KS, Gibson, PS, Coffin, CS. Pregnancy following liver transplantation: review of outcomes and recommendations for management. Can J Gastroenterol. 2012;26(9):621–626.Google Scholar
Rahim, MN, Long, L, Penna, L, et al. Pregnancy in liver transplantation. Liver Transpl. 2020 Apr;26(4):564–581.Google Scholar
Ramirez, CB, Doria, C. Pregnancy after liver transplantation. Best Pract Res Clin Obstet Gynaecol. 2014 Nov;28(8):1137–1145.Google Scholar
UK medical eligibility criteria for contraceptive use, 2016; amended Sept 2019. Available at www.fsrh.org. Accessed September 29, 2020.Google Scholar
Women in Hepatology Group; Italian Association for the Study of the Liver (AISF). AISF position paper on liver transplantation and pregnancy: Women in Hepatology Group, Italian Association for the Study of the Liver (AISF). Dig Liver Dis. 2016 Aug;48(8):860–868.Google Scholar
Zullo, F, Saccone, G, Donnarumma, L, et al. Pregnancy after liver transplantation: a case series and review of the literature. J Matern Fetal Neonatal Med. 2019 Oct;21:1–8.Google Scholar

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