Casele H L, Laifer S A
Division of Maternal Fetal Medicine, Northwestern University Medical School, Evanston Hospital, IL 60201, USA.
Semin Perinatol. 1998 Apr;22(2):149-55. doi: 10.1016/s0146-0005(98)80047-5.
This article reviews the reported experience with pregnancy after liver transplantation and describes obstetric risks and medical issues that the maternal fetal medicine specialist has a reference for managing these pregnancies and for providing appropriate preconception counseling. Women who undergo liver transplantations have a higher risk of preeclampsia, worsening hypertension, preterm premature rupture of membranes, anemia, small for gestational age, preterm delivery, and cesarean section than the normal obstetric population. Women with preconceptional renal dysfunction appear to be at greatest risk for pregnancy complications. Women who conceived within 6 months of transplant had a high risk of rejection. Reproductive-aged recipients of liver allograft should receive contraception and preconception counseling. In an appropriately timed and planned pregnancy, women who undergo liver transplantations can have successful pregnancies with little risk to their allograft function.
本文回顾了肝移植术后妊娠的相关报道经验，并描述了产科风险和医学问题，以便母胎医学专家在管理这些妊娠以及提供适当的孕前咨询时有参考依据。接受肝移植的女性发生子痫前期、高血压病情恶化、胎膜早破、贫血、小于胎龄儿、早产和剖宫产的风险高于正常产科人群。孕前存在肾功能不全的女性似乎发生妊娠并发症的风险最高。移植后6个月内怀孕的女性排斥反应风险较高。育龄期肝移植受者应接受避孕和孕前咨询。在适时且计划好的妊娠中，接受肝移植的女性可以成功妊娠，且对其移植肝功能的风险很小。
