Orgul Gokcen, Ozkan Esra Uyanik, Celik H Tolga, Beksac M Sinan
Department of Obstetrics and Gynecology, Division of Perinatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Department of Pediatrics, Division of Neonatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Clin Exp Hepatol. 2017 Dec;3(4):212-214. doi: 10.5114/ceh.2017.71445. Epub 2017 Nov 14.
Women of childbearing age with autoimmune hepatitis (AIH) are now able to get pregnant. The progress of the disease during pregnancy is not well clarified yet. The first pregnant woman had cirrhosis secondary to AIH, and she delivered by cesarean section. The patient had severe thrombocytopenia at the time of hospitalization. Unfortunately, she died due to massive thromboembolism at the 24 hour after delivery. The other patient had three recurrent abortions with a diagnosis of AIH. Low-dose low molecular weight heparin and low-dose acetylsalicylic acid along with low-dose prednisolone were administered during the course of the following pregnancies. The following pregnancies ended up with a living child. There is a high morbidity and mortality risk for both fetus and mother. Hepatic performance of the patients, thrombotic events, inflammatory disorders and autoimmune system activation must be the main concerns together with necessary precautions.
患有自身免疫性肝炎（AIH）的育龄女性现在能够怀孕。然而，孕期疾病的进展情况尚未完全明确。首例患有AIH继发肝硬化的孕妇通过剖宫产分娩。该患者住院时伴有严重血小板减少症。不幸的是，她在产后24小时因大面积血栓栓塞死亡。另一名患者被诊断为AIH，有三次复发性流产。在随后的妊娠过程中，给予低剂量低分子量肝素、低剂量乙酰水杨酸以及低剂量泼尼松龙治疗。随后的几次妊娠均产下活婴。胎儿和母亲均面临较高的发病和死亡风险。患者的肝功能、血栓形成事件、炎症紊乱以及自身免疫系统激活都必须作为主要关注点，并采取必要的预防措施。
