Sujana Kumar Vidya, Qumosani Karim, Taylor Taryn, Sun Dongmei
Department of Medicine, Scarborough Health Network, Toronto, Canada.
Department of Medicine, Schulich School of Medicine and Dentistry, Western University, Toronto, Canada.
Obstet Med. 2022 Mar;15(1):56-58. doi: 10.1177/1753495X20972828. Epub 2020 Dec 8.
Cirrhosis is a multisystemic condition in which pregnancy is uncommon; however, the combination may lead to a higher incidence of spontaneous fetal loss and complications such as progressive jaundice, ascites and variceal bleeding. Here we present a 21-year-old woman who presented at 14 weeks' gestation with new jaundice and a two-month history of melena consistent with pre-existing cirrhosis of unclear aetiology. She delivered a healthy male infant at 34 weeks and five days of gestation vaginally with good haemostasis. In the literature, maternal mortality rates have been reported in up to 61% of these women, however, this risk is likely lower now with modern endoscopic therapies and improved access to blood products. There is limited information about labour and delivery in cirrhosis, although the best outcomes to date have been described in well-compensated women.
肝硬化是一种多系统疾病，孕期较为少见；然而，二者并存可能会导致自然流产发生率升高，以及诸如进行性黄疸、腹水和静脉曲张破裂出血等并发症。我们在此报告一名21岁女性，她在妊娠14周时出现新发黄疸，并有两个月的黑便病史，符合病因不明的原有肝硬化。她在妊娠34周零5天时经阴道分娩出一名健康男婴，止血情况良好。在文献中，这些女性的孕产妇死亡率报道高达61%，不过，随着现代内镜治疗方法的应用以及血液制品获取途径的改善，目前这种风险可能降低了。关于肝硬化患者分娩的信息有限，尽管迄今为止最佳分娩结局见于病情得到良好代偿的女性。
