Aprosina Z G, Ignatova T M, Shekhtman M M
Ter Arkh. 1987;59(8):76-82.
In the course of chronic active hepatitis (CAH) 61 patients (CAH of virus etiology in 75% and of obscure etiology in 25%) had 211 pregnancies which terminated in delivery in 80 (38%) cases, spontaneous abortions in 12 (6%) cases, and medical abortions in 119 (56%) cases. In most cases there was successful termination of pregnancies without deterioration resulting from liver disease including patients treated adequately with immunosuppressive drugs. CAH exacerbations associated with pregnancies and their outcomes were noted in 23 (38%) cases. They were more frequent and more severe in patients with liver cirrhosis (LC) unrecognized by the time of pregnancy. There were no mothers' deaths. CAH made a negative effect on the course and outcomes of pregnancies: the frequency of premature delivery was 9%, that of cesarean-5%, perinatal mortality-75%. Of 74 infants born alive 2 died within the first months after birth as a result of congenital liver cirrhosis, a double kidney was detected in one infant, the rest of the infants were healthy. Problems of therapeutic tactics in CAH patients after onset of pregnancy are discussed.
在慢性活动性肝炎（CAH）病程中，61例患者（75%为病毒病因所致的CAH，25%为病因不明的CAH）共妊娠211次，其中80例（38%）分娩，12例（6%）自然流产，119例（56%）药物流产。多数情况下妊娠得以成功终止，未因肝病恶化，包括接受免疫抑制药物充分治疗的患者。23例（38%）患者出现与妊娠相关的CAH病情加重及其相应结局。在妊娠时未被识别出肝硬化（LC）的患者中，病情加重更为频繁和严重。无孕产妇死亡。CAH对妊娠过程及结局产生负面影响：早产发生率为9%，剖宫产率为5%，围产儿死亡率为75%。74例活产婴儿中，2例因先天性肝硬化在出生后最初几个月内死亡，1例婴儿检测出双肾，其余婴儿健康。文中讨论了CAH患者妊娠后治疗策略的问题。
