Successful Delivery In Women With Advanced Liver Cirrhosis: Report Of 3 Cases

Kim, Jin Hwi; Lee, Hyun Jeong; Moon, Hee Bong; Ahn, Hyun Young; Lee, Jee Hyun; Kim, Sa Jin; Shin, Jong Chul; Kim, Soo Pyung

Abstract

There is high prevalence of HBV infection in Asian countries including South Korea. In fact, 8% of Koreans are HBV carriers, and 20-25% of them progress to liver cirrhosis. Liver cirrhosis, known to be the last stage of chronic liver diseases, is the most prominent cause of death in Korean males in their forties. However, women participation to social activities increased and also increased psychological stress that changed life style now days, and due to increased alcohol consumption liver disease has become a serious problem in korean women population. But as liver cirrhosis usually occurs after the menopause, and decreased fertility in cirrhotic patients, pregnancy in women with liver cirrhosis is rare. However, improved general care increased pregnancy rates and reports of pregnancy in women with liver disease worldwide. Studies on the effect of liver cirrhosis on pregnancy and the effect of pregnancy on the clinical progression of liver cirrhosis have not been well established, and the continuation of pregnancy in a patient with liver cirrhosis has been controversial. Recently, it has become favorable for the argument that pregnancy can be kept as long as liver function is maintained at certain level and portal hypertension is mild. The most common and fatal maternal complication is gastrointestinal hemorrhage. It increases maternal mortality and intrauterine developmental defect resulting in neonatal morbidity. Although South Korea is an area of high prevalence of HBV infection, there are few reports of pregnancies in women with liver cirrhosis. Recently, we have experienced the 3 cases of pregnancies in women with progressive liver cirrhosis who became pregnant. Although thrombocytopenia and increased coagulopathy complicated the pregnancy course, all women delivered healthy babies and were discharged in good condition.