Pruvot F R, Declerck N, Valat-Rigot A S, Canva-Delcambre V, Gambiez L, Labalette M, Gottrand F, Noel C, Puech F, Paris J C
Service de Chirurgie, Hôpital Calmette, Lille.
Gastroenterol Clin Biol. 1996;20(5):457-61.
We report 7 pregnancies which occurred from 1988 to 1995 in 5 women who underwent liver transplantation. The immunosuppression regimen associated cyclosporine, azathioprine and prednisone.
Mean age at conception was 25. During pregnancy, cholestasis occurred in 2 women. None of the patients experienced rejection. An increase in serum creatinine was observed in 3 cases. Serum uric acid increased in the third trimester of pregnancy in 6 cases, associated with arterial hypertension in 3 cases. In 4 cases, toxemia led to premature delivery. Seven childbirths occurred between the 34th and 38th week of gestation, by vaginal delivery (n = 3) or caesarean section (n = 4). Newborn weights ranged from 1,350 g to 3,100 g. A favorable outcome was observed in all mothers, with a follow-up ranging from 2 months to 7 years after delivery.
These results suggest that a successful pregnancy is possible after liver transplantation in young women with normal hepatic function and treated with cyclosporine. The risk of toxemia is mainly related to renal function before pregnancy.
我们报告了1988年至1995年间5例接受肝移植的女性发生的7次妊娠情况。免疫抑制方案包括环孢素、硫唑嘌呤和泼尼松。
受孕时的平均年龄为25岁。孕期有2名女性发生胆汁淤积。所有患者均未发生排斥反应。3例患者血清肌酐升高。6例患者在妊娠晚期血清尿酸升高，其中3例伴有动脉高血压。4例患者因子痫前期导致早产。7例分娩发生在妊娠第34至38周，通过阴道分娩（n = 3）或剖宫产（n = 4）。新生儿体重在1350克至3100克之间。所有母亲均预后良好，产后随访时间为2个月至7年。
这些结果表明，肝功能正常且接受环孢素治疗的年轻女性肝移植后有可能成功妊娠。子痫前期的风险主要与妊娠前的肾功能有关。
