Unsolved issues of pregnancy in liver cirrhosis

  • Authors: Kotzev AI.1, Tanchev LS.2, Pavlov C.S.3, Tanchev SY.4
  • Affiliations:
    1. Clinic of Gastroenterology, University Hospital “Alexandrovska”, Medical University
    2. Acibadem City Clinic Tokuda Hospital
    3. I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russian Federation (Sechenov University)
    4. Obstetric Clinic, University Hospital "Dr. Georgi Stranski", Department of obstetrics and gynecology, Medical University
  • Issue: Vol 91, No 4 (2019)
  • Pages: 114-117
  • Section: Articles
  • URL: https://ter-arkhiv.ru/0040-3660/article/view/33646
  • DOI: https://doi.org/10.26442/00403660.2019.04.000145
  • Cite item

Abstract


Pregnancy in patients with liver cirrhosis and portal hypertension occurs very rare, because of their significantly derailed reproductive functions. Тhe risks for the mother and the fetus are connected with worsening of the portal hypertension, progression of decompensated liver cirrhosis and development of its complications: liver failure, ascites, hepatorenal syndrome, hepatic encephalopathy and variceal hemorrhage, and with increased incidence of spontaneous abortions and abnormal uterine bleeding. The decision for continuation of the pregnancy in cirrhotic patients must be based on individual approach and a multidisciplinary team consisting of obstetricians, hepatologists, anesthesiologists, surgeons and hematologists must participate in the therapy. We are presenting a clinical case with 34 years old pregnant woman with Child-Pugh class C cirrhosis and untreated chronic viral hepatitis C. The patient was admitted in emergency with abortus imminens, vaginal bleeding, anemia, thrombocytopenia and impaired hemostasis. The pregnancy was interrupted in the Department of obstetrics and gynecology due to the high risk for mother’s life. Later the patient developed severe disseminated intravascular coagulation (DIC) syndrome with life-threatening uterine bleeding. The DIC syndrome and the bleeding were resolved after therapy in intensive care unit and the patient was discharged from the hospital with stable vital signs.

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About the authors

A Iskrenov Kotzev

Clinic of Gastroenterology, University Hospital “Alexandrovska”, Medical University

Sofia, Bulgaria

L Stoyanov Tanchev

Acibadem City Clinic Tokuda Hospital

Sofia, Bulgaria

Ch Savov Pavlov

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russian Federation (Sechenov University)

Moscow, Russia

S Yotov Tanchev

Obstetric Clinic, University Hospital "Dr. Georgi Stranski", Department of obstetrics and gynecology, Medical University

Pleven, Bulgaria

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