Liver Unit, Queen Elizabeth Hospital, Birmingham, UK.
Centre for Liver Research, Institute of Immunology and Inflammation, and National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, The Medical School, University of Birmingham, Birmingham, UK.
Aliment Pharmacol Ther. 2020 Aug;52(3):420-429. doi: 10.1111/apt.15908. Epub 2020 Jun 29.
The prevalence of chronic liver disease in women of child bearing age is increasing, leading to a higher incidence of pregnancy in this cohort. Chronic medical conditions have a significant adverse effect on maternal morbidity and mortality. To date, reviews on this topic have been written either from a hepatology or obstetrics viewpoint, and no specific guidelines are available solely for the management of chronic liver disease in pregnancy.
To produce a comprehensive review on the clinical management of women with chronic liver disease during pregnancy, addressing the risks of pregnancy to mother and child, how these risks can be ameliorated, and what additional considerations are required for management of chronic liver disease in pregnancy.
Data were collected up to May 2020 from the biomedical database PubMed, national and international guidelines in gastroenterology and hepatology.
During pregnancy, women with cirrhosis are more likely to develop decompensated disease, worsening of portal hypertension, and to deliver premature infants.
The risks associated with pregnancy can be ameliorated by advanced planning, assessing risk using the model for end stage liver disease score and risk reduction through varices screening. A multidisciplinary approach is paramount in order to minimise complications and maximise the chance of a safe pregnancy and birth for mother and baby.
生育年龄段女性慢性肝病的患病率正在增加，导致该年龄段妊娠的发生率更高。慢性疾病对产妇发病率和死亡率有显著的不良影响。迄今为止，关于这一主题的综述要么是从肝病学角度，要么是从妇产科角度撰写的，尚无专门针对妊娠合并慢性肝病管理的具体指南。
对妊娠合并慢性肝病女性的临床管理进行全面综述，探讨妊娠对母婴的风险，以及如何减轻这些风险，以及妊娠合并慢性肝病管理需要额外考虑哪些因素。
截至 2020 年 5 月，从生物医学数据库 PubMed、胃肠病学和肝病学的国家和国际指南中收集数据。
妊娠期间，肝硬化女性更有可能发生失代偿性疾病、门静脉高压恶化和早产。
通过先进的规划、使用终末期肝病模型评分评估风险以及通过静脉曲张筛查降低风险，可以减轻与妊娠相关的风险。为了将并发症的风险最小化，并使母婴安全妊娠和分娩的机会最大化，多学科方法至关重要。
