Thomas Jefferson University, 605 College Bldg., 1025 Walnut St., Philadelphia, PA 19107, USA.
Thomas Jefferson University, 605 College Bldg., 1025 Walnut St., Philadelphia, PA 19107, USA.
Best Pract Res Clin Obstet Gynaecol. 2014 Nov;28(8):1137-45. doi: 10.1016/j.bpobgyn.2014.07.022. Epub 2014 Aug 16.
Women constitute >30% of patients undergoing liver transplantation (orthotopic liver transplantation, OLT) and about 8% are of reproductive age, and 5% are pediatric females who will mostly survive into adulthood and will consider pregnancy. Although pregnancy in OLT recipients is associated with an increased incidence of hypertension, preeclampsia, anemia, preterm deliveries, and cesarean section, acute rejection and liver allograft loss do not appear to be increased and pregnancy-related maternal death is uncommon. The incidence of structural malformations in the newborn of liver transplant recipients is reported to be 4.4%, which is similar to the rate of 3-5% in the US general population. Patients are advised to defer conception for at least 1-2 years after OLT, while maintaining effective contraception. Pregnancy after OLT usually results in a favorable maternal and neonatal outcome when there is coordinated pre- and perinatal care by a multidisciplinary team composed of obstetric-gynecologists, and a transplant team.
女性占接受肝移植（原位肝移植，OLT）的患者的>30%，约 8%处于生育年龄，5%为儿科女性，她们大多数将成年并考虑怀孕。虽然 OLT 受者怀孕会增加高血压、子痫前期、贫血、早产和剖宫产的发生率，但急性排斥反应和肝移植物丢失似乎并未增加，与妊娠相关的母亲死亡也不常见。据报道，肝移植受者新生儿的结构畸形发生率为 4.4%，与美国普通人群的 3-5%相似。建议患者在 OLT 后至少推迟 1-2 年怀孕，同时保持有效的避孕措施。在由妇产科医生和移植团队组成的多学科团队进行协调的产前和围产期护理后，OLT 后怀孕通常会产生有利的母婴结局。
