Bröker Mirelle E E, Ijzermans Jan N M, van Aalten Susanna M, de Man Robert A, Terkivatan Türkan
Department of Surgery, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
Int J Hepatol. 2012;2012:725735. doi: 10.1155/2012/725735. Epub 2012 Dec 24.
Because of the risk of hormone-induced growth and spontaneous rupture of hepatocellular adenoma (HCA) during pregnancy, special considerations are required. Due to the scarcity of cases, there is no evidence-based algorithm for the evaluation and management of HCA during pregnancy. We think it should be questioned if it is justified to discourage pregnancy in all women with HCA. The biological behavior of this benign lesion might be less threatening than presumed and a negative advice concerning pregnancy has great impact on the lives of these young female patients. The balance between the pros and cons of hepatic adenomas and pregnancy should be reconsidered. In our center, pregnancy in women with an HCA up to 5 cm is no longer discouraged in close consultation with the patient, her partner, and members of the liver expert team.
由于孕期激素诱导的肝细胞腺瘤(HCA)生长及自发破裂的风险,需要特殊考虑。鉴于病例稀缺,尚无基于证据的孕期HCA评估与管理算法。我们认为,对于所有患有HCA的女性都不鼓励怀孕是否合理值得质疑。这种良性病变的生物学行为可能没有想象中那么具有威胁性,而关于怀孕的负面建议对这些年轻女性患者的生活有很大影响。肝腺瘤与怀孕的利弊平衡应重新审视。在我们中心,对于直径达5厘米的HCA女性患者,在与患者、其伴侣及肝脏专家团队成员密切协商后,不再不鼓励怀孕。