| Management of hepatocellular adenoma during pregnancy. | |
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MedLine Citation:
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PMID: 21094555 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND & AIMS: Hepatocellular adenoma in pregnant women requires special considerations because of the risk of hormone induced growth and rupture. To prevent these potential lethal complications, pregnancy is either often discouraged or the surgical resection of large adenomas is recommended. It may be questioned whether it is justified to deny a young woman a pregnancy, as the biological behaviour of hepatocellular adenoma may be less threatening than presumed. In this study we establish the management of hepatocellular adenoma during pregnancy based on our own experience and literature. METHODS: Twelve women with documented hepatocellular adenoma were closely monitored during a total of 17 pregnancies between 2000 and 2009. Their files were reviewed. RESULTS: In four cases, hepatocellular adenomas grew during pregnancy, requiring a Caesarean section in one patient (two pregnancies) at 36 and 34weeks because of an assumed high risk of rupture. In one case radiofrequency ablation therapy was applied in the first trimester to treat a hormone sensitive hepatocellular adenoma, thereby excluding potential growth later in pregnancy. No intervention was performed in the other 14 cases and all pregnancies had an uneventful course with a successful maternal and fetal outcome. CONCLUSIONS: A "wait and see" management may be advocated in pregnant women presenting with a hepatocellular adenoma. In women with large tumours or in whom hepatocellular adenoma had complicated previous pregnancies, surgical resection may be recommended. In women with smaller adenomas it may no longer be necessary to discourage pregnancy. |
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Authors:
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Johanna E Noels; Susanna M van Aalten; Dirk J van der Windt; Niels F M Kok; Rob A de Man; Turkan Terkivatan; Jan N M Ijzermans |
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Publication Detail:
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Type: Journal Article Date: 2010-09-22 |
Journal Detail:
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Title: Journal of hepatology Volume: 54 ISSN: 0168-8278 ISO Abbreviation: J. Hepatol. Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-02-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8503886 Medline TA: J Hepatol Country: England |
Other Details:
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Languages: eng Pagination: 553-8 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. |
Affiliation:
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Department of Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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