Gülümser Çağrι, Kinap Mahir, Yanik Filiz Bilgin, Sahin Uysal Nihal, Moray Gokhan, Haberal Mehmet
Department of Obstetrics and Gynecology, University of Health Sciences, Ankara, Turkey.
Department of General Surgery, Baskent University School of Medicine, Baskent, Turkey.
J Matern Fetal Neonatal Med. 2020 Apr;33(7):1218-1224. doi: 10.1080/14767058.2018.1517317. Epub 2018 Sep 25.
To investigate pregnancy outcomes and to define preventative measures against to risk factors and complications in pregnancy after liver transplantation. Secondary aim is to report postpartum allograft functions in these patients. This is a case series study. All pregnant women with liver transplantations performed in our hospital were enrolled. Patients' hospital medical records, electronic records Neonatal Intensive Care Unit (NICU) records were used to collect data. Obstetric characteristics and antenatal complications, risk factors, pregnancy and neonatal outcomes, all aspects of liver transplant variables and allograft functions after pregnancy were studied. A total of 11 patients were included in the study. All of them were singleton. Mean maternal age was 29.3 ± 3.9 years. And mean gestational week of delivery was 37.2 ± 2.2. 78% of the women were delivered at term (>37 weeks) only two babies were preterm and discharged from NICU without any complications. Birth weight (gr median ± SD) was 2575 ± 345. Five (45%) patients were nulliparous, majority of the cases (8/11, 72%) were conceived of pregnant with natural way. Live birth rate was 81% (9/11). Only one patient for each has suffered from fetal growth restriction, maternal anemia, maternal hyperthyroidism, and ulcerative colitis. Vaginal bleeding was seen in five women during the pregnancy. There was no maternal death, stillbirth or neonatal death. The mode of delivery for all live birth pregnancies was C-section. And none of them was emergency C-section. No complication of allograft function was seen after pregnancy. Pregnancy in women with liver transplantation is not associated with poor pregnancy outcomes and complications for both the mother and the neonates when these patients followed up at tertiary referral center with multidisciplinary approaches.
为了研究肝移植术后妊娠结局,并确定针对妊娠风险因素和并发症的预防措施。次要目的是报告这些患者产后的同种异体移植物功能。这是一项病例系列研究。纳入了在我院接受肝移植的所有孕妇。使用患者的医院病历、电子记录、新生儿重症监护病房(NICU)记录来收集数据。研究了产科特征、产前并发症、危险因素、妊娠和新生儿结局、肝移植变量的各个方面以及妊娠后的同种异体移植物功能。共有11名患者纳入研究。她们均为单胎妊娠。产妇平均年龄为29.3±3.9岁。平均分娩孕周为37.2±2.2周。78%的女性足月分娩(>37周),仅有2例早产,且从NICU出院时无任何并发症。出生体重(中位数±标准差,克)为2575±345。5名(45%)患者为初产妇,大多数病例(8/11,72%)通过自然方式受孕。活产率为81%(9/11)。各有1名患者分别患有胎儿生长受限、母体贫血、母体甲状腺功能亢进和溃疡性结肠炎。5名女性在孕期出现阴道出血。无孕产妇死亡、死产或新生儿死亡。所有活产妊娠的分娩方式均为剖宫产。且均非急诊剖宫产。妊娠后未观察到同种异体移植物功能并发症。当这些患者在三级转诊中心采用多学科方法进行随访时,肝移植女性的妊娠与不良妊娠结局及母婴并发症无关。