Cirrhosis and Pregnancy

Disclaimer: This article is not intended as medical advice for patients but is for informational purposes only.

liver-disease-in-pregnancy

Cirrhosis is when parts of the liver become hardened by damage done over time. Cirrhotic sections of liver unlike normal liver segments cannot repair itself.

Fortunately this is a relatively rare scenario as most patients develop cirrhosis later in life. However, cirrhosis is becoming more common due to rising rates of obesity. Pregnant women with cirrhosis  (which may be undiagnosed) can run into difficulty.

The biggest risk is bleeding, because pregnancy leads to an increased circulating volume of blood and the foetus compresses the inferior vena cava.

ivc-compression

Most of this bleeding occurs in the oesophagus and normally has to be prevented surgically either by banding of these vessels – called varices or inserting a shunt called a TIPS or transhepatic-portosystemicshunt. Pregnant women should ideally have foetal monitoring while undergoing any procedures.

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Large liver-specialist centres need to be involved, especially if other problems subsequently develop. Early delivery may sometimes be necessary.

As long as the mother’s health is optimised then the same is normally true for the baby as in normal pregnancy.

Hepatitis

Hepatitis of any kind can be more serious in pregnancy. It needs to be managed with specialist input. Certainly chronic hepatitis B warrants some form of management at some point prior to birth in order to minimise the risk of transmission to the foetus.

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