Maternal Foetal Unit, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Oporto, Portugal; Instituto Ciências Biomédicas Abel Salazar, Oporto University, Oporto, Portugal.
Instituto Ciências Biomédicas Abel Salazar, Oporto University, Oporto, Portugal; Clinical Immunology Unit, Centro Hospitalar Universitário do Porto, Oporto, Portugal.
Best Pract Res Clin Obstet Gynaecol. 2020 Oct;68:23-31. doi: 10.1016/j.bpobgyn.2020.03.007. Epub 2020 Mar 16.
Autoimmune hepatitis (AIH) is a rare liver disease of autoimmune aetiology that classically affects women at reproductive age. Diagnosis of AIH is not always straightforward, and other causes of chronic liver disease must be excluded. Pregnancy in patients with AIH is associated with an increased risk of adverse maternal and foetal outcomes. In older studies, the incidence of adverse outcomes was high, with a large number of flare-ups, maternal deaths, and perinatal complications. In the most recent series, improved care based on multidisciplinary surveillance, a larger number of patients treated before and during pregnancy, and reduced incidence of cirrhosis at conception have led to better maternal outcomes and a live-birth rate similar to that in the general population. Nonetheless, AIH is still associated with preterm birth, foetal growth restriction, and unpredictable liver flares, and it represents a group of patients who need close evaluation during pregnancy.
自身免疫性肝炎（AIH）是一种罕见的自身免疫性病因引起的肝脏疾病，经典地影响育龄期女性。AIH 的诊断并不总是那么直接，必须排除其他慢性肝病的病因。患有 AIH 的孕妇发生不良母婴结局的风险增加。在以前的研究中，不良结局的发生率较高，有大量的病情发作、孕产妇死亡和围产期并发症。在最近的系列研究中，基于多学科监测的更好的护理、更多的患者在怀孕前和怀孕期间得到治疗，以及受孕时肝硬化发生率的降低，导致了更好的孕产妇结局和与一般人群相似的活产率。尽管如此，AIH 仍与早产、胎儿生长受限和不可预测的肝发作有关，它代表了一组在怀孕期间需要密切评估的患者。
