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Good Maternal and Fetal Outcomes for Pregnant Women With Primary Biliary Cirrhosis.
MedLine Citation:
PMID:  24321209     Owner:  NLM     Status:  Publisher    
BACKGROUND & AIMS: Up to 25% of patients diagnosed with primary biliary cirrhosis (PBC) are of childbearing age. However, little is known about disease course during pregnancy.
METHODS: We performed a retrospective analysis of women with PBC during pregnancy using a representative large cohort of patients attending the Liver Center at Toronto Western hospital from January 1979 through June 2009 (n=306). Statistical analysis was performed using 'R' statistical software.
RESULTS: We identified 32 women (50 pregnancies) who either became pregnant after a diagnosis of PBC or in whom pregnancy led to diagnosis. Liver biochemistry remained stable in most patients (70%) throughout pregnancy. However, 23/32 patients (72%) had a flare in biochemical disease activity post-partum, which was unrelated to biochemical disease activity before conception (P=.53), or during the gestational period (P=.14). No adverse maternal events were observed during pregnancy or post-partum, and only 2/32 of women (6%) developed progressive disease following delivery. De novo pruritus developed during pregnancy in 17/32 women (53%), whereas itch that existed before conception worsened for 4 patients. Fifteen/21 women (71%) with pregnancy-related pruritus required symptom-specific therapy. Twenty-nine/32 women (91%) had at least 1 successful live birth; adverse fetal outcome was not influenced by biochemical disease activity before conception (P=.24) or during pregnancy (P=1.00).
CONCLUSION: Pregnancy in women with PBC is frequently symptomatic but mostly uneventful. Most women maintain stable liver biochemistry during pregnancy, although post-partum biochemical exacerbations are common.
Palak J Trivedi; Teru Kumagi; Nadya Al-Harthy; Catalina Coltescu; Stephen Ward; Angela Cheung; Gideon M Hirschfield
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-12-6
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  -     ISSN:  1542-7714     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2013-12-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.
Liver Center, Toronto Western Hospital, Toronto, Ontario, Canada; NIHR Biomedical Research Unit and Centre for Liver Research, University of Birmingham, Birmingham, UK.
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