Marinaccio M, Pinto V, Sambati G S, Papandrea D, De Veteris M
I Clinica Ostetrica e Ginecologica, Università degli Studi di Bari.
Minerva Ginecol. 1992 May;44(5):273-6.
A 32 yr-old woman suffering from an unsuspected primary biliary cirrhosis (PBC), completed an uneventual pregnancy. She only experienced diffuse pruritus and subicterus, which misled to an antepartum diagnosis of intrahepatic cholestasis of pregnancy. The most remarkable points of the reported case are: (a) the younger age of onset of PBC; (b) the paucisymptomatic course of PBC; (c) the rarity of PBC-associated pregnancy (only 15 previous instances in 12 patients, from a review of the literature); (d) the uncomplicated course of pregnancy for both the mother and the fetus, which is the exception rather than the rule, in such a condition. The present observation calls our attention to the possible existence of an underlying latent liver cirrhosis in pregnant women with pruritus, jaundice and mild alterations of liver function indexes. This association, which is expected to increase in frequency in the near future, may have important implications in the management of pregnancy.
一名32岁患有未被怀疑的原发性胆汁性肝硬化(PBC)的女性完成了一次平安无事的妊娠。她仅经历了全身性瘙痒和轻度黄疸,这导致产前被诊断为妊娠肝内胆汁淤积症。该报告病例最显著的特点是:(a)PBC发病年龄较轻;(b)PBC症状轻微;(c)PBC合并妊娠罕见(根据文献综述,12例患者中此前仅有15例);(d)母亲和胎儿的妊娠过程均未出现并发症,在这种情况下这是个例外而非普遍规律。本观察结果提醒我们注意,对于有瘙痒、黄疸及肝功能指标轻度改变的孕妇,可能存在潜在的隐匿性肝硬化。这种关联预计在不久的将来会更加常见,可能会对妊娠管理产生重要影响。