Korean J Obstet Gynecol.  2011 May;54(5):252-255. 10.5468/KJOG.2011.54.5.252.

Massive ascites after cesarean section in a patient with liver cirrhosis

• Heo EY
• Hwangbo JH
• Lee YH
• Kim MJ
• Bae JY
• Seong WJ

• KMID: 2078020
• DOI: http://doi.org/10.5468/KJOG.2011.54.5.252

Abstract

Pregnancy is a rare event in patients with cirrhosis. But recently, improvements in the treatment of chronic liver disease have resulted in higher conception rates and more successful pregnancy outcomes. A 32-year-old woman with liver cirrhosis underwent cesarean section due to aggravated preeclampsia at 31 3/7 weeks of gestation. After 3 days postoperatively, she complained abdominal distension, and abdominal sonography showed massive amount of ascites. Following paracentesis and administration of diuretics, her course was uneventful. There are increasing numbers of case reports and case series of pregnancy in liver cirrhosis. Nevertheless, morbidity and mortality remains higher than that of the general pregnant population. It is therefore important for physicians caring for pregnant patients with cirrhosis to understand how to approach potential complications and tailor management regimens appropriately.

Keyword

Liver cirrhosis; Pregnancy; Ascites; Complication

MeSH Terms

Adult
Ascites
Cesarean Section
Diuretics
Female
Fertilization
Fibrosis
Humans
Liver
Liver Cirrhosis
Liver Diseases
Paracentesis
Pre-Eclampsia
Pregnancy
Pregnancy Outcome
Diuretics

Reference

1. Russell MA, Craigo SD. Cirrhosis and portal hypertension in pregnancy. Semin Perinatol. 1998. 22:156–165.

2. Steven MM. Pregnancy and liver disease. Gut. 1981. 22:592–614.

3. Ahn YO. Strategy for vaccination against hepatitis B in areas with high endemicity: focus on Korea. Gut. 1996. 38:Suppl 2. S63–S66.

4. Tan J, Surti B, Saab S. Pregnancy and cirrhosis. Liver Transpl. 2008. 14:1081–1091.

5. Britton RC. Pregnancy and esophageal varices. Am J Surg. 1982. 143:421–425.

6. Pajor A, Lehoczky D. Pregnancy and extrahepatic portal hypertension. Review and report on the management. Gynecol Obstet Invest. 1990. 30:193–197.

7. O'Mahony S. Endoscopy in pregnancy. Best Pract Res Clin Gastroenterol. 2007. 21:893–899.

8. Shaheen AA, Myers RP. The outcomes of pregnancy in patients with cirrhosis: a population-based study. Liver Int. 2010. 30:275–283.

9. Murthy SK, Heathcote EJ, Nguyen GC. Impact of cirrhosis and liver transplant on maternal health during labor and delivery. Clin Gastroenterol Hepatol. 2009. 7:1367–1372.

10. Kim JH, Lee HJ, Moon HB, Ahn HY, Lee JH, Kim SJ, et al. Successful delivery in women with advanced liver cirrhosis: report of 3 cases. Korean J Obstet Gynecol. 2002. 45:1421–1426.

11. Lee KJ, Moon JB, Han SY, Kim MH, Kee SH, Park JS, et al. 3 cases of pregnancies in patients with liver cirrhosis. Korean J Obstet Gynecol. 1999. 42:2132–2137.